Speakers Brief CV & Abstracts

Lígia Rocha

Brief CV

·   Integrated Master Degree (2012) in Dentistry by Instituto Universitário Ciência Saúde do Norte (IUCS) – CESPU, Portugal.

·   Diploma in Esthetic Dentistry (2013) by University of Gothenburg & Plenido Dental School.

·   PhD student in Doctoral Programme in Biological Sciences Applied to Health of the IUCS-CESPU.

·   Monitor in Department of Conservative Dentistry Department of Health Sciences (IUCS-CESPU), Portugal.

·   Lecturer of Operative Dentistry in the Postgraduate Program in Adhesive Dentistry (IUCS-CESPU).

·   Researcher in group UNIPRO- Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS-CESPU).

·   Author and co-author of peer-reviewed scientific publications in the field of biomaterials in dental materials and oral rehabilitation.

·   Clinical practice dedicated to Restorative Dentistry.

Maria João

Calheiros Lobo

Brief CV

•   Researcher at UNIPRO – Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS-CESPU).

•   Degree in Medicine and in Dentistry – University of Porto, Portugal

•   Master’s Degree in Clinical and Social Gerontology – University of Santiago de Compostela

•   Mini-Residency in Biomaterials and Adhesive Dentistry – University of Minnesota, USA

•   Post-Graduation in Oral Implantology, Oral Surgery, Esthetic Dentistry, Orthodontics, and Chronobiology and Sleep Medicine

•   “Oral Designer” certificate – Dental Line Training Center, Guimarães.

•   Invited Assistant Professor, since 1992, at the Conservative Dentistry Service, Dental Sciences Department (IUCS-CESPU)

•   FCT investigator – “Proteomic study of salivary disorders induced by diabetes”- PTDC/QUI/72683/2006; “Salivary proteins as dental caries protection” – POCI/QUI/5890/2004

•   Author and co-author of articles in international peer-reviewed journals in the field of salivary proteomics, and biomaterials in dental materials and oral rehabilitation (Scopus h-index 12)

•   Private clinical practice mainly in Esthetic Dentistry, Implantology, and Orthodontics.

Teresa Pinho

Brief CV

•   PhD in Orthodontics and Pediatric Dentistry by University of Porto

•   Associate Professor with Aggregation at the University Institute of Health Sciences (IUCS-CESPU)

•   Aggregation at the Faculty of Dental Medicine of the University of Porto

•   Member of the coordination at UNIPRO – Oral Pathology and Rehabilitation Research Unit

•   Researcher at the Institute of Molecular and Cellular Biology- IBMC, i3S-University of Porto

•   More than 120 articles published in international and national journals

•   Certificate of Excellence in Orthodontic Clinical Practice by the French Board of Orthodontics

•   Specialist in Orthodontics by the Portuguese Dental Association

•   Specialist in Pediatric Dentistry by the Portuguese Dental Association

•   President of the Portuguese Society of Orthodontics

Tooth agenesis: clinical and in vitro analysis for rehabilitation materials.

Maxillary lateral incisors agenesis (MLIA) is a condition that significantly compromises smile esthetics with particular concern in younger patients. Treatment of unilateral or bilateral MLIA has proven to be challenging, commonly involving different approaches: close the space moving the canine onto edentulous space with subsequent remodeling to mimic the appearance of the lateral incisor; or open the space for a subsequent replacement of the missing lateral incisor by prosthetic units. Unfortunately, both treatments are expensive, time-consuming, complex, and controversial.

Adequate alveolar ridge dimensions are a prerequisite for dental implants, with bone and soft tissue grafts often required and possible long-term tissue instability. Instead, minimal invasive approaches can be applied, using resin-bonded bridges (RBB) with appropriate adhesive joints, and be used both as interim or non-provisional approaches, especially in growing patients.

Resin-matrix composites used for esthetic remodeling and luting cementation have Bisphenol A (BPA) and derivates in its composition, toxic compounds considered estrogenic disrupters.

The work aims to determine resin-matrix composite and monolithic ceramics’ different chemical and mechanical properties when used in the rehabilitation of MLIA. Additionally, we studied the influence of BPA on the chemical and mechanical performance of resin-matrix composites.

Manuel Alves-Ferreira

Brief CV

Miguel Alves-Ferreira is a Junior Research at Instituto de Investigação e Inovação em Saúde (i3S) and an Invited Auxiliary Professor at ICBAS- Univ. Porto. His main research interest is in the genetic of complex and mendelian genetic diseases, focusing nowadays in Primary Headaches and Familial Amyloidotic Polyneuropathy (FAP), using a multi-omics approach. MAF completed PhD in Biomedical Sciences (2019) at ICBAS/IBMC-i3S University of Porto in collaboration with the The Scripps Research Institute (TSRI, California). Postgraduate (2017) in Graduate Research for Advance Study Program at TSRI, USA. Currently a co-PI in project Interreg V A España-Portugal (POCTEP).


Orofacial structures development are a complex mechanism regulated by sequential and reciprocal epithelial-mesenchymal interactions, controlled by activators and inhibitors involved in several pathways. Disturbances in these signaling cascades can lead to abnormalities from odontogenesis to the musculoskeletal system, resulting in alterations in the formation of the normal teeth number and in pain. Despite environmental disturbances, many multifactorial oral diseases (including tooth agenesis and temporomandibular disorders (TMD)) are mainly genetically controlled. To date, more than 200 genes have been identified in tooth development. Primary headache disorders (PHD), specifically migraine, are known to be strongly associated to TMD, sharing some patterns of orofacial pain. Besides that, both disorders have a major genetic component associated to the onset of the pathophysiological mechanisms, which are already studied. Mutations/variants in any of these strictly balanced signaling cascades may cause arrested odontogenesis and/or other oral defects. Thus, our studies intend to study the genetic alterations that can trigger oral diseases development and their comorbidities. The importance of these studies resides in the opportunity to explore recent advances in the genetic profile of these pathologies that may serve as a therapeutic targets and in future diagnostic and/or monitoring techniques that could aid the treatment in the early stages.

Vanessa Marcelino

Brief CV

·    PhD student in Biomedical Sciences UNIPRO – Oral Pathology and Rehabilitation Research Unit.

·    Invited assistant of the Curricular Unit of Anatomy at the University Institute of Health Sciences (IUCS-CESPU)

·    Postgraduate Diploma in Advanced Biomimetic Oral Rehabilitation at the University Institute of Health Sciences (IUCS-CESPU)

·    Specialisation Course in Oral Implantology at University of Santiago de Compostela (Spain)

·    Orthodontic Clinical Course – Trevisi Zanelato “MBT Philosophy”

·    Postgraduate Diploma in Interceptive Orthodontics at the University Institute of Health Sciences (IUCS-CESPU)

Maria Paço

Brief CV

·   PhD in Physiotherapy, in the field of temporomandibular disorders, by University of Porto

·   Principal Adjunct Professor at Escola Superior de Saúde do Vale do Ave (IPSN – ESSVA)

·   Pedagogical and scientific coordinator of the post-graduated course in Orofacial Pain – Temporomandibular Disorders (CESPU)

·   Researcher at UNIPRO – Oral Pathology and Rehabilitation Research Unit.

·   Vice-president of the scientific committee of the Portuguese Society of Temporomandibular Disorders and Orofacial Pain (SPDOF).

·   Member of the board of the Interest Group in Musculoskeletal Physiotherapy, of the Portuguese Association of Physiotherapists.

·   Co-author of several posters and oral communications at national and international conferences.

·   Author of several publications in national and international journals.

Teresa Pinho

Brief CV

·    PhD in Orthodontics and Pediatric Dentistry by University of Porto

·    Associate Professor with Aggregation at the University Institute of Health Sciences (IUCS-CESPU)

·    Aggregation at the Faculty of Dental Medicine of the University of Porto

·    Member of the coordination at UNIPRO – Oral Pathology and Rehabilitation Research Unit.

·    Researcher at the Institute of Molecular and Cellular Biology- IBMC, i3S-University of Porto

·    More than 120 articles published in international and national journals

·    Certificate of Excellence in Orthodontic Clinical Practice by the French Board of Orthodontics

·    Specialist in Orthodontics by the Portuguese Dental Association

·    Specialist in Pediatric Dentistry by the Portuguese Dental Association

·    President of the Portuguese Society of Orthodontics

Temporomandibular disorders and chewing function: a multifactorial approachTemporomandibular disorders are an umbrella term, which covers a set of musculoskeletal and neuromuscular conditions involving the masticatory musculature, the temporomandibular joint, and/or their associated structures. It presents a challenge to health professionals due to its complexity, which is evident in aspects such as diagnostic methods, treatment options, associated comorbidities and the socioeconomic impact they represent. One of the most common comorbidities found in TMD patients is the presence of psychosocial aspects that seem to play an important role in the development and aggravation of this condition. Furthermore, due to the functional changes that may be present in TMD patients, it seems that such impairment may cause disorders during the chewing process.

Additionally, and considering that the use of esthetic aligners emerged as a response to the demand for more aesthetic and comfortable treatments, the literature has no results regarding the effects of their use on TMD signs and/or symptoms. This seems of paramount importance, once during treatment, artificial occlusal interferences are created, which may result in less efficient stable contacts, compared to conventional techniques, and may interfere with chewing efficiency and a possible appearance of TMD signs/symptoms.

Aline Gonçalves

Brief CV

·    Licenciada em Medicina Dentária pelo IUCS, em 2002.

·    Mestre em Ortodontia pelo IUCS, em 2009.

·    Assistente Convidada de Clínica Odontopediátrica II e III no Mestrado Integrado em Medicina Dentária do IUCS, desde 2003.

·    Docente da Pós-Graduação em Ortodontia Intercetiva Odontopediátrica no IUCS, desde 2011.

·    Docente da Pós-Graduação em Clínica Integrada Odontopediátrica no IUCS, de 2010 a 2017.

·    Docente do Curso de Mestrado em Ortodontia no IUCS, desde 2014.

·    Máster Damon em 2016.

·    Especialista em Odontopediatria pela Ordem dos Médicos Dentistas, desde 2017.

·    Aluna do Programa Doutoral em Ciências Biomédicas, IUCS, desde 2018.

·    Membro da Sociedade Portuguesa e Espanhola de Odontopediatria, Sociedade Portuguesa de Pediatria, Sociedade Portuguesa de Ortodontia.

·    Prática exclusiva em Odontopediatria e Ortodontia.

Selma Pascoal

Brief CV

·    Licenciatura em Medicina Dentária em 2008 (não integrada em Bolonha) – Universidade Fernando Pessoa

·    Mestrado em Ortodontia – Instituto Universitário de Ciências de Saúde do Norte (2013/2016)

·    Pós-graduação em Ortodontia Interceptiva Odontopediátrica 8ª edição no Instituto Universitário de Ciências de Saúde do Norte (2017/2018)

·    Doutoranda no programa doutoral de Ciências Biológicas Aplicadas à Saúde – Instituto Universitário de Ciências da Saúde (2018)

·    Monitora Clínica da disciplina de Odontopediatria no IUCS-CESPU, desde setembro de 2018.

·    Pós-graduação em Ortodontia com Alinhadores – Sistema Invisalign- 1ª edição Instituto Universitário de Ciências da Saúde (2019)

·    Revisora científica da revista ORTOCLINICA (Sociedade Portuguesa de Ortodontia)

Teresa Pinho

Brief CV

•   PhD in Orthodontics and Pediatric Dentistry by University of Porto

•   Associate Professor with Aggregation at the University Institute of Health Sciences (IUCS-CESPU)

•   Aggregation at the Faculty of Dental Medicine of the University of Porto

•   Member of the coordination at UNIPRO – Oral Pathology and Rehabilitation Research Unit

•   Researcher at the Institute of Molecular and Cellular Biology- IBMC, i3S-University of Porto

•   More than 120 articles published in international and national journals

•   Certificate of Excellence in Orthodontic Clinical Practice by the French Board of Orthodontics

•   Specialist in Orthodontics by the Portuguese Dental Association

•   Specialist in Pediatric Dentistry by the Portuguese Dental Association

•   President of the Portuguese Society of Orthodontics

Orthodontic tooth movement with aligners: bioeffects and implications of photobiomodulation and vibratory stimulation

The most notable orthodontic advance in the last decade has been the introduction of digitally fabricated aligners to move the teeth in small, progressive sequences. Currently, the largest provider of aligners is Invisalign®. All these optimizations, innovations, and advances share one common goal – the reduction of treatment time.

Tooth movement involves both bone remodeling and modeling, which requires a coordinated action from osteoclasts and osteoblasts in response to mechanical loading. Moreover, inflammatory mediators are released after mechanical stimulus or injury, triggering the biologic process associated with orthodontic tooth movement.

Vibration and photobiomodulation (PBM) are non-invasive methods that can be conjugated with the orthodontic treatment to increase the teeth movement rate.

It is accepted that vibration can stimulate the differentiation of osteoclasts from hematopoietic cells by increased blood flow. Similarly, PBM stimulates osteoclast, osteoblast and fibroblast proliferation and thereby affects bone remodeling and tooth movement through ATP production and cytochrome C activation.

Studies on the effects of mechanical vibrations and PBM in orthodontic movement are inconsistent, and these differences may arise from the use of different protocols, tooth movement mechanics or outcome measurements. Further multicenter randomized controlled clinical trials and prospective studies are deemed essential to gather valid evidence of vibratory and PBM stimulus effectiveness in OTM acceleration.

The work aims to justify the relevance of using dental movement accelerators in cases where more complex movements are required, in which the Invisalign system demonstrates a reduced predictability/effectiveness.

Cristina Manzanares Cespedes

Brief CV

·    Born the 28th November 1960 in Barcelona, Spain. M.D. (Faculty of Medicine, Autonomous University of Barcelona, Spain, 1985), PhD (Faculty of Medicine, Catholic University of Louvain, Belgium, 1988).

·    Associated Professor of Human Anatomy and Embryology (Faculty of Dentistry, University of Barcelona, 1989-1992). Profesora Titular de Universidad (Ordinary Professor) since 1992 (Faculty of Dentistry, presently School of Dentistry, Faculty of Medicine and Health Sciences, University of Barcelona, Spain). Invited professor in the Instituto Universitàrio de Cièncias da Saùde, (CESPU, Gandra, Portugal) and the University of Brescia (Italy).

·    Secretary General ADEE (Association for Dental Education in Europe (2016-2020); EU Liaison Officer ADEE Executive Commitee. Secretary General IFDEA (International Federation of Dental Educators and Associations).

·    Associated Editor of “European Journal of Dental Education” and “European Journal of Anatomy”.

·    Research Topics

·    Craniofacial development: formation of skull bones, odontogenesis, bone malformations, skull, face and stomatognathic system. Morphological studies (macroscopic, microscopic and ultramicroscopic anatomy, elemental analysis, confocal microscopy) of calcified tissues (teeth and bones). Osseointegration and biomaterials: calcified tissues and their role in the osseointegration of biomaterials and bone regeneration. Dental, medical, anatomical education.

·    ORCID: https://orcid.org/0000-0002-4585-4953

·    https://www.researchgate.net/profile/Maria-Cristina_Manzanares_Cespedes

Osteoimmunology, biomaterials and alveolar bone regeneration

Bone is a complex tissue with a hierarchical structure that can be characterized from the nanoscale to the macroscale. Its main functions are to provide support and protection to the organs and the body movements, as well as to participate in systemic homeostasis. Bone renews by way of an equilibrated continuum called “bone remodeling”, which starts with osteoclastic resorption and continues with osteoblastic apposition. Remodeling is the bone response in front of numerous factors, the changes of shape and/or stress described by Wolff (1892), who also mentioned mechanisms by which remodeling occurs via “debris of the product of inflammation”, thus anticipating the role of cytokines and growth factors.

In the last years, numerous studies have explored the influence of the osteoimmunomodulation, the effect of the immune environment on the cells responsible of the bone remodeling, in order to restore the anatomical integrity of bone when

disturbed by trauma or injury. A wide range of paracrine signals allows the immunocompetent cells to generate an osteoimmune environment aimed to heal the osseous tissue by ways of pro-inflammatory and anti-inflammatory signals. Alveolar bone constitutes a particular niche, because of its origin, development and exposition to a very hostile environment. Periodontitis, a systemic chronic inflammatory disease, causes an imbalance between pro-inflammatory and anti-inflammatory cytokines, that mediates the progressive destruction of soft and hard tissues around the oral biomaterials causing bleeding and bone loss.

Various strategies have been developed to improve the osteoimmunomodulatory characteristics of bone biomaterials to stimulate bone growth during all stages of bone healing, from the initial inflammatory stage to the bone remodeling. Bone regeneration results of various strategies to increase the osteoimmunomodulation of biomaterials will be discussed.

Fernando Guerra

Brief CV·

Full Professor from the Faculty of Medicine of the University of Coimbra

Director of the Center of Innovation and Research in Oral Sciences

Director of the Institute of Implant Dentistry and Prosthodontics

Clinical Studies in Implant Dentistry – Relevant aspects to consider

This presentation has the purpose to address important aspects in the design and publication of clinical studies in implant dentistry, such as: organizationals issues, primary and secondary outcomes, flowcharts, size calculation, methodologies of analysis, explanation of results, etc. Randomized clinical trails are emphasized with examples of studies performed at the Center for Innovation and Research in Oral Sciences from the Faculty of Medicine the University of Coimbra.

Arthur R. G. Cortes

Brief CV

Prof. Arthur Rodriguez Gonzalez Cortes, DDS, MSc, PhD is an Associate Professor of Oral Radiology and Digital Dentistry at the Department of Dental Surgery, Faculty of Dental Surgery, University of Malta, where he conducts research focused mostly on Digital Dentistry. He got his DDS, MSc and PhD degrees from University of São Paulo (Brazil), and completed a one-year postdoctoral fellowship in Radiology at Harvard University, (Boston, USA). He has published more than 50 international scientific articles in journals indexed on the pubmed website, most of them from funded projects. In addition, Prof. Cortes is an oral implantologist and radiologist with 15 years of experience. As an ITI director, Prof. Cortes has been lecturing on Digital Dentistry as an invited speaker in different countries such as Brazil, Spain, Denmark, Korea, Peru and Malta, including a visiting professor appointment at University of Okayama (Japan).

Aspects of CAD-CAM systems influencing digital workflow outcomes

The continuous development of computer-aided design and computer-aided manufacturing (CAD-CAM) has led to the creation of several new techniques and methodologies in oral rehabilitation. In consequence, recent studies have aimed at addressing the accuracy of CAD-CAM methods and its impact on the quality of the resulting CAD-CAM prostheses. This lecture will offer detailed information on CAD-CAM accuracy, which can also be affected by factors associated with the image-acquisition procedures.

António Ferraz

Brief CV·    Orcid: 0000-0003-0289-8064

·    Degree in Dentistry (1999-CESPU).

·    Postgraduate Diploma in Implantology and Reconstructive Surgery (Pierre Fauchard Foundation)

·    Postgraduate Diploma in Implantology (IUCS – CESPU).

·    Phd Student in Biomedical Sciences (IUCS – CESPU).

·    Integrated Investigator at Oral Pathology and Rehabilitation Research Unit (UNIPRO) of University Institute of Health Sciences (IUCS)

·    Guest Assistant of Conservative Dentistry – Dep. of Dental Sciences (IUCS-CESPU).

·    Scientific and Pedagogical Coordinator, Professor of the Postgraduate Program in Endodontics (IUCS-CESPU).

Leukocyte – Platelet Rich Fibrin effect in human peripheral blood and its antimicrobial action

Leukocyte and platelet rich fibrin (L-PRF) is one of the platelet concentrates used to support regeneration and healing process. Many studies showed possible immunological and antibacterial properties of L-PRF. We perform an in vitro study to analyze the effect of L-PRF on platelet activation, platelet-leukocytes interactions and antimicrobial activity, important components in the healing process. Molecular biomarkers related with platelet activation and platelet-leukocyte interactions were analyzed by means of flow cytometry when L-PRF exudate was added to whole blood platelets. L-PRF membrane was used to evaluate antimicrobial activity using several ATCC strains. Our experimental design allows to evaluate platelet activation and analyze molecular biomarkers of other immune cells and platelet-leukocyte interactions. From the results obtained we can conclude that L-PRF can be a valuable tool in healing process, efficient in activating platelets of whole blood and inhibiting microbial growth. In this presentation we will try to demonstrate that, the use of L-PRF exudate, in addition to L-PRF membrane, presents some advantages that must be considered in clinical trials.

Keywords Autologous platelet concentrates · L-PRF · Whole blood platelets · Antimicrobial activity · Flow cytometry · Regenerative dentistry

Rita Pereira

Brief CV
Comparison between flowable and conventional resin-matrix composites regarding chemical composition and polymerization.Introduction:

Technological development of resin-matrix composites has provided several options of commercial materials for enhanced esthetical outcomes. Low viscosity (flowable) resin-matrix composites are mostly indicated for preventive restorations, such as: minimally invasive occlusal class I or II restorations, pit and fissure sealants and inner layer for class II posterior resin-matrix composite placement in sealing of gingival margins. However, the low filled flowable resin-matrix composites are more susceptible to wear in stress bearing areas and therefore may not be the clinicians’ first choice. The development of new organic matrix and inorganic fillers might overcome current limitations of flowable resin-matrix composites.

Aim: The aim of this study was to evaluate the shape, chemical composition and size of inorganic fillers in the microstructure of recent conventional and flowable resin-matrix composites by using optical and scanning electron microscopy.

Materials and Methods: Six resin-matrix composites with different inorganic content were prepared. The flowable resin-matrix composites showed the following filler content in weight (%wt): 76, 62.5, and 60%. Two traditional nanohybrid resin-matrix composites specimens with 80 and 89wt% filler content in weight and one submicron-scale hybrid resin-matrix composite with 74 wt% fillers were also assessed. Disc-shaped specimens with 2mm thickness and a diameter of 6mm were light cured for 40s according to the standard guidelines. Specimens were cross-sectioned using graded SiC grit-papers under automatic polishing and distilled water lubrication. After 10 minutes of ultrasonic cleaning in propanol and distilled water, surfaces were inspected by optical microscopy followed by scanning electron microscopy (FEGSEM, FEI Nova 200) on secondary (SE) and backscattered electron (BSE) modes coupled to energy dispersive spectroscopy 5-15 kV within magnification up to 50,000 to accurate measurements of nanoparticles size. Fillers were identified by using EDAX-Pegasus X4M (EDS/EBSD) coupled to the FEGSEM unit. Regarding polymerization was also investigated the effect of inappropriate polymerization on oral tissues and its effects of oral and systemic toxicity.

Results: The flowable resin-matrix composites with 62.5 wt% fillers showed irregular particles with particle size ranging from 0.1 up to 3.0 µm. Another flowable resin-matrix composite with 60 wt% fillers showed amorphous silica and zinc oxide particles ranging from 0.02 up to 1.4 µm. The third flowable resin-matrix composite revealed nanoparticles with average particle size of 20-40nm and glass ceramic irregular particles with 1 μm. Nano-hybrid resin composites revealed silica nano-particles  at 20-40 nm and micro-scale particles (zirconia glass fillers, barium glass, prepolymerized fillers and ytterbium fluoride) ranging from 0.1 to 3.0 μm. Submicron-hybrid resin-matrix composite showed particles range between 0.02 and 1.5 μm. Defects, such as micro-scale voids and pores, were also found revealing the handling sensitivity of the technique. Regarding polymerization, it was also noted that mechanical properties and biocompatibility are correlated to DC, which depends on sufficient amount of light reaching all restoration, it was also verified that increase time polymerization exposure could raise in pulpal temperature and polymerization devices could cause cellular lesions. The degree of conversion of resin matrix composites affects the release of potentially toxic substances that are present within the resin composite.

Conclusion:  The flowable resin-matrix composites with 76 wt% with nanosized fillers revealed a similar type, shape and high percentage of fillers when compared with high filled traditional nanohybrid composites. Regarding filler´s constitution, highly filled flowable composites were morphologically similar to the traditional resin-matrix composites. When compared with submicron-hybrid resin matrix composites, highly filled flowable resin-matrix composites revealed organized nanosized particles with irregular shapes which allow a highly loaded resin composite. Regarding polymerization, it could be conclude that doubling the exposure time may significant increase pulpal temperature, which should be considered by the clinicians when they want to achieve higher DC% for better clinical performance of the restoration. The choice of polymerization device is extremely important   to achieve a    reduction   of   composite   toxicity   is possible if the curing mode is adapted to the used composite.

Valter Fernandes

Brief CV·    www.linkedin.com/in/vfendodontics·    0000-0003-4432-5424

·    Invited Professor Post-Graduation Program on Endodontics at IUCS – CESPU

·    Monitor of the Conservative Dentistry Department at IUCS – CESPU

·    Student of the Doctoral Program in Biomedical Sciences – IUCS – CESPU –2020/2024

·    Post-Graduation on Endodontics of Dental School of University of Lisbon – 2015

·    Post-Graduation on Endodontics of IUCS CESPU – 2010

·    Graduation in Dentistry of Dental School of University of Porto – 2008

·    Member Direction board of the Portuguese Society of Endodontics – 2020/2023

·    Author scientific publications on Endodontics, Conservative Dentistry and Dental Materials

·    Clinical Practice dedicated to Microscopic Endodontics since 2010.

Resin cement around commercial glass fiber-reinforced composites posts.

Anatomical differences along the root canal cause an variable and unpredictable distance between the post and the intracanal dentin surface. Such space is filled with different volume of resin-matrix cement after cementation. Thick layers of resin cements are prone to defects like macro- and microscale pores, cracks, and voids that create stress concentration zones leading do root fractures. The main objective of our study was to evaluate the microstructure and spacial distribution of fibers of glass fiber-reinforced composites (GFRC) posts to tooth root intracanal dentin by microscopic analysis. Extracted human premolars with completely formed apex were used in this study. The anatomic crowns were sectioned, and all teeth were endodontically treated. Groups of specimens were divided according to the cementation with different endodontic post systems as follow: A) ParaPost Fiber LuxTM (Coltène, Whaledent Inc, USA); B) Rebilda GTTM (VOCO, Germany); C) Angelus ExactoTM (Angelus, Brazil). After cementation, specimens were cross-sectioned at 90 degrees relative to the plane of the GFRC post to resin-matrix cement interface. Then, specimens were inspected by optical microscopy (OM) (Leica DM 2500 MTM, Leica Microsystems, Germany) and scanning electron microscopy (SEM) (JSM-6010 LV, JEOL, Japan). Microscopic analyses revealed a wide variation of resin-matrix cement thickness around the endodontic GFRC posts. Also, the shape of the root canal preparation caused a variation in the thickness of the remnant tooth tissues. Defects such as micro-scale pores, cracks, and voids were also detected by OM and SEM analyses. The root canal preparation can promote a decrease in the thickness of the remnant tooth tissues that can increase the risks of clinical failures by fracture.

Keywords: Fiber posts; Rehabilitation; Dentin Thickness; Fitting

8th April 2022Conference on Advances in Research on Oral Cancerconvened by UNIPRO and the WHO Collaborating Centre on Oral Cancer

Alfândega do Porto – Sala D. Luís

Adalberto Miranda-Filho

Brief CV

Dr Adalberto Miranda Filho is as an applied epidemiologist with a track record in evaluating the impact of cancer and its causes across populations internationally. As background, he holds an MPH and a PhD in Epidemiology in the Oswaldo Cruz Foundation (FIOCRUZ-RJ). Over the last years, he has been working at IARC, as a Scientist (Epidemiologist) within the IARC Monographs Programme (IARC/IMO), responsible for identifying environmental factors that are carcinogenic hazards to humans. Prior to the above post, he held an IARC Postdoctoral Fellowship within the Cancer Surveillance Branch (IARC/CSU).

The incidence and trends of oral and oropharyngeal cancer in Europe.

We presented here the European statistics on oral cavity and oropharynx cancers using the comprehensive set of national estimates, as well as the high-quality recorded data provided by population-based cancer registries (PBCR) in Europe. Overall, cancer in the oral cavity and oropharynx represent the 16th and 24th most common malignant neoplasm in Europe, respectively, in 2020. Estimated age-standardized incidence rates for oral cavity cancer was 13.3 and 1.1 for oropharynx. Trends are diverse, with oral cavity and pharynx (combined) cancer incidence rates continuing to decrease for males, and incidence rates still stable in females, e.g., Italy, France, Germany, Spain, and U.K. Other countries, namely Portugal and Poland, ncidence rates have either slightly increased or are still stable for males and females, since the 2000s. Global and regional descriptions of international patterns and trends in oral and oropharyngeal cancer are informative in providing insight into the shifting epidemiologic patterns and the potential prevention of these tumours.

Saman Warnakulasuriya

Brief CV

Saman Warnakulasuriya is an emeritus professor of Oral Medicine and Experimental Pathology at King’s College London, UK, and was the Chairman of the Oral Medicine Division at King’s College Hospital and at Guy’s Hospital, London from 2005 -2015. He has acted as the Director of the WHO Collaborating Centre on Oral Cancer since 2005. He has made major contributions in cancer epidemiology, oral medicine, and experimental pathology. He is a leading expert on human carcinogens, that cause mouth cancer. He was the recipient of the Distinguished Scientist Awards from the International Association of Dental Research in both Oral Medicine and Pathology (2014) and in Global Oral Health (2021). He was elected a Fellow of King’s College in 2019. In 2016 he was appointed as an Officer of the British Empire by Her Majesty the Queen for his services to Medicine

Major risk factors and controversies in the causation of oral cancer.

A risk factor is defined by the World Health Organisation as “Any attribute, characteristic, or exposure of an individual which increases the likelihood of developing a disease or injury”. Tobacco, betel quid and harmful use of alcohol are established risk factors for oral cancer that have been known for decades. Tobacco exposure includes smoking cigarettes, cigars, pipes, bidis, chewing tobacco, and using snuff. The risk conferred by cigarette smoking is more than 3-fold compared to never smokers. Cigar and/or pipe smoking have similar magnitude of risks to cigarette smoking. Bidis are locally manufactured tobacco products, mainly smoked in South Asia and carry a higher risk. Involuntary smoking is an established risk factor for lung cancer and a recent meta-analysis based on 5 case-control studies reported an association between involuntary smoking with oral cavity cancer. To date the evidence on e-cigarettes or waterpipe smoking and the risk of oral cancer are limited.

Both case-control and cohort studies support the independent effect of alcohol drinking on risk of oral cancer, with strong dose–response relationships measured by frequency or duration of alcohol drinking. Considering different types of alcoholic beverages there is no conclusive evidence on whether any particular alcoholic drink carries a relatively higher risk; the dominant alcohol types in specific regions are associated with the greatest risk.

Interactions between tobacco and alcohol is estimated to be on a multiplicative scale and a meta-analysis confirmed their synergistic effect for oral cavity cancer. According to a cohort study in the US population, the attributable fraction for tobacco and/or alcohol was 66.6%.

Betel quid with or without tobacco is confirmed to be carcinogenic to man and areca nut which is the primary ingredient in betel quid is classified by the IARC a class 1 carcinogen. A meta- analysis based on studies from India and Taiwan confirmed relative risks that are higher than for tobacco. The attributable risk on oral cancer from regular betel quid use among Indian and Taiwan populations is close to 50%.

In addition to these major risk factors discussed above several factors with limited evidence that are still considered controversial are reported in the literature. These include Mate drinking (a hot beverage mostly consumed in some Latin American countries), chronic mechanical irritation, microbes that result in oral dysbiosis, poor oral hygiene, chronic inflammation, consumption of red meat, immunosuppression and occupational exposures.

Graham Ogden

Brief CV

Professor Graham R Ogden (BDS U Sheffield), become head of Oral and Maxillofacial Clinical Sciences, Univ of Dundee UK in 2001. He was on the GDC specialist list for Oral Surgery and Oral Medicine. He was President of the Association of British Academic Oral & Maxillofacial Surgeons (ABAOMS) from 2012-2015. His awards for his research into oral cancer (early diagnosis/field change/alcohol) include the T.C. White Prize Lectureship, RCPSG (1990); British Society for Oral Medicine Prize (1990); Senior Colgate Prize, British Society for Dental Research (1992); Ian Stevenson Award for Public Engagement with Research 2012 and IADR Distinguished Scientist Award for Oral Medicine & Pathology Research (2019). He was Dean of the Dental Faculty and Vice President (Dental) of the Royal College of Physicians & Surgeons of Glasgow from 2016 to 2019.

Alcohol: mechanisms of carcinogenesis.

The role of alcohol as a risk factor for oral cancer (with and without tobacco) will be briefly reviewed with a more detailed look at the possible mechanisms behind the development of cancer as a result of exposure to alcohol.

Any study evaluating alcohol as a risk factor for cancer must consider the potential errors in evaluating exposure to alcohol. In the UK it was found that there was a 40% under reporting of what we say we drink compared to general alcohol sales. (Boniface & Shelton 2013).

It is generally regarded that the oxidation of alcohol to acetaldehyde (a known mutagen and carcinogen) is the most significant event in the potential pathway to cancer. That acetaldehyde can arise from the metabolism of alcohol in the liver is well known, but it is also now recognised that this can arise in the oral mucosa, salivary glands and from the bacteria in our mouth. It can even arise from inhaling tobacco smoke (or eating common foods).

An overview of the various mechanisms proposed to help explain why cancer might arise in the head and neck region is briefly reviewed (Ogden 2018) In particular the role of polymorphisms in the two key enzymes involved in the metabolism of alcohol; ADH (alcohol dehydrogenase) and ALDH (aldehyde dehydrogenase). The catalase and cytochrome P450 pathways for alcohol metabolism being regarded as less significant.

The author will then draw upon areas of his (and others) research looking at oral cell structure and function as a result of exposure to alcohol before considering further avenues worthy of research.

Pablo Ignacio Varela Centelles

Brief CV

Lecturer in Oral Surgery at the Medical & Dental School of the University of Santiago de Compostela (Spain) and head of primary dental care units of the Galician Health Service for 25 years, he qualified as a dental surgeon at the Complutense University in Madrid. Later, he obtained a master’s degree from the University of Sheffield (UK) in Periodontology. He also holds a master’s degree in Public Health & Community Dentistry from the University of Santiago de Compostela, where he was granted a PhD with a dissertation on survival to oral cancer and its associated factors.

He has authored 100+ scientific papers, supervised 12 PhD thesis, and leaded 5 competitively funded research projects and several contracts with the private sector. He was awarded 5 patents.

Dr. Varela-Centelles is the current leader of the Dermatology and Craniofacial Pathology research group of the Santiago de Compostela Health Research Institute.

Delays in diagnosis of oral cancer in primary care- a systematic review.

Oral cancer incidence does not seem to be under control and a high proportion of these patients keep being diagnosed at advanced disease stages. Several factors have been linked to this phenomenon, including diagnostic delay. The most important component of oral cancer diagnostic delay is the time needed for the patient to contact a healthcare professional once the person has noticed a bodily change. The aim of this systematic review was to analyse what happens since this first contact until referral for hospital care. To achieve this goal, we checked four databases (PubMed®, Embase®, Scopus®, and SciELo®) to obtain 727 references. Finally, 11 papers (mostly Europeans and published in this century) reporting on 1,778 patients were selected.

The median length of the primary care interval ranged from 6 to 39.5 days. These patients were mainly seen by family physicians who needed from one to six consultations to refer the case for specialised care. The odds ratio for being referred at an early stage ranged from 0.10 (95% CI: 0.01 – 0.99) to 1.36 (95%CI: 0.52 – 3.53).

António Mano Azul

Brief CV

Antonio Mano Azul, MD, DDS, MsC, Specialist in Stomatology

Professor and co- Head of Department of Oral Surgery, Oral Medicine and Maxillofacial Surgery. Instituto Universitario Egas Moniz, Monte da Caparica, Portugal (Egas Moniz – Cooperativa de Ensino Superior)

Coordinator of the National Program for Promotion of Oral Health and PIPCO (Intervention Program for Oral Cancer), General Directorate of Health (DGS), Ministery of Health.  Portugal Chief Dental Officer

Founder member and Past-President of the European Association of Oral Medicine. President of the Portuguese Academy of Oral Medicine.

Recent public health interventions in Portugal to control oral cancer: Screening & Early detection.

Portugal started a couple of years ago a public program to improve the rate of early detection of oropharyngeal cancer and OPML and consequently improve the 5 years survival rate and the patients quality of life after treating oral cancer.

A “collateral side-effect” was to improve literacy on oropharyngeal cancer of Portuguese dentists and general medical practitioners, involving them as main players of this National Program (PIPCO).

We are now in a phase of improving the PIPCO software after testing it for 5 years now and of launching in the near future a literacy effort for the population with the help of the EU Mobile App for Cancer Prevention (Europer’s Beating Cancer Plan).

Luís Monteiro

Brief CV

Luis Monteiro, PhD (Pathology), MSc (Oncology), DDS

·    Auxiliar Professor at the Instituto Universitário de Ciências da Saúde (IUCS), CESPU.

·    Director of Oral Pathology and Rehabilitation Research Unit UNIPRO, IUCS.

·    Specialist in Oral Surgery from the Portuguese Dental Association (OMD).

·    Diploma in Oral Medicine by the European Association of Oral Medicine (EAOM).

·    Coordinator of the Postgraduate course in Oral Laser Applications at IUCS.

·    Coordinator of the Postgraduate course in Oral Medicine and Pathology at IUCS.

·    Board member (vice-president) of the Portuguese Academy of Oral Medicine (APMO).

·    Board member of World Federation of Laser in Dentistry – European (WFLD-ED)

·    Region 4 representative board member of European Association of Oral Medicine (EAOM).

Use of technology towards early diagnosis of oral cancer.

Oral potentially malignant disorders includes several diseases that carry an increased risk for oral cancer. Oral leukoplakia (OL) is the most typical one and the others includes oral lichen planus, erythroplakia or oral submucous fibrosis. Tobacco and alcohol seems to be the most common etiologic factors in addition to Human papillomavirus infection, although with conflicting data. The correct diagnosis is based not only on the clinical characteristics but also on histologic features and many times is challenging. In the view of this, several adjuncts instruments have been reported to help a more accurate diagnosis of oral malignancy. In this lecture we will discuss the usefulness of several diagnosis adjuncts instruments or tests for detect oral cancer.



 José M. Aguirre

Brief CV

· Degree and PhD in Medicine and Surgery. Universidad del País Vasco / EHU. Extraordinary Doctorate Award
· Medical Specialist in Pathology (MIR)
· Medical Specialist in Stomatology
· Associate Professor of Stomatology Universidad del País Vasco / EHU 1980-85
· Titular Professor of Stomatology. Universidad del País Vasco / EHU 1985-2009
· Catedrático Professor of Stomatology. Universidad del País Vasco / EHU 2009-current
· Director of the Master of Oral Pathology. UPV / EHU
· Former Head of the Dental Clinic Service and of the Oral Medicine and Oral and Maxillofacial Pathology Units of the Dental Clinic Service UPV / EHU
· Former Chair of the Department of Stomatology II UPV/EHU
· Former Coordinator of the Diplomate in Oral Medicine of the Iberoamerican Academy of Oral Medicine and Bucal Pathology
· Recognition of 5 Sexenios (6-years) of Research (1st of 12 years). Ministry of Education and Universities. Government of Spain.
· Author of more than 250 scientific publications
· Author of 27 books and chapters in books.
· Director of 33 Doctoral Theses.
· Responsible for the area of Stomatology in the Multidisciplinary Training and Research Unit. (UFI11/25) Universidad del País Vasco / EHU.
· Head of the Consolidated Research Group “Oral Cancer and Precancer. Oral and Maxillofacial Pathology”. Universidad del País Vasco / EHU and Basque Country Gobernment.
· Principal Investigator in more than 30 externally funded research projects (FIS -ICIII, MINECO, Fundación Gangoiti, Basque Country Gobernment, UPV).
· Member of the Ethics Committee for Research Involving Human Subjects (CEISH) UPV/EHU
· Evaluator of ANECA, MINECO, University Evaluation Agency of Valencia, University Evaluation Agency of Madrid.
· Founding member and former Vice President of the Spanish Society of Oral Medicine (SEMO).
· Former President of the Iberoamerican Academy of Oral Pathology and Medicine (AIPMB).
· Medal of Honor of the Spanish Society of Oral Medicine (SEMO).
· President of the Scientific Commission of the Spanish Society of Oral Medicine (SEMO).
· President of the Oral and Dental Health Advisory Commission of the Basque Country (CASBE). Basque Country Gobernment.
· Associate Editor of the journal Medicina Oral Patología Oral Cirugía Bucal
· Member of the Collaborating Group WHO/OMS for the OPMD 2020


Oral cancer is an important malignancy in humans and squamous cell carcinoma (SCC) is the most frequent type, accounting for over 90%. OSCC still has a very poor prognosis with survival at 5 years of less than 50%. In this important oral disease, the histopathological study is crucial for its early diagnosis and to establish a prognosis.
A prognostic marker in cancer (CPM) is a patient or tumor characteristics that predict outcome (usually survival) independent of the treatment. CPM are useful to stratify patients into groups and to guide the most appropriate treatment in each case. CPM are mostly useful in the early stages of neoplastic disease.
An ideal CPM should be: specific, sbjective and measurable, biologically meaningful, easily accessible, and have a low cost. Certain histopathological data associated with OSCC meet these requirements.
The analysis of the oral pathologist is essential in the early diagnosis of OSCC. The assessment of epithelial dysplasia is still the gold standard in the prognostic evaluation of malignant development.
Since the last century, attempts have been made to predict the biological behavior of OSCC from histopathology, beginning with the assessment of tumor differentiation, followed by multiple malignancy grading systems, scoring tumor and host factors, obtaining disparate and controversial results.
In recent times, some aspects have shown sufficient scientific evidence to be considered prognostic markers such as: depth of invasion, pattern of invasion, tumor budding, perineural invasion, lympho-vascular invasion, bone invasion, inflammatory response, tumor-stroma ratio, status of surgical margins, and extranodal extension. Therefore, in all cases of OSCC it is mandatory: 1) To analyse all the material of the tumoral specimen and cervical dissection, 2) To look carefully at all the slides, 3) To check all possible histopathological and prognostic data, 4) To follow a Specific Histopathological Protocol.
In this lecture, I will review these prognostic data and the importance of histopathologic examination in OSCC.
Now we must say that OSCC is not a single and uniform neoplastic disease, it is a heterogeneous group of malignant neoplasms of the oral mucosa that show a similar histopathology
A good histopathological study is essential in all OSCC cases to recognise key prognostic data.
Early diagnosis and treatment remain the most important elements to be confident of a good prognosis in OSCC.
“Still, the prognosis of a patient with OSCC depends on the first health professional who diagnoses it”

Pierre Saintigny

Brief CV

Pierre Saintigny, MD, PhD, is a medical oncologist and physician-scientist at regional and OECI-certified cancer center Centre Léon Bérard (CLB). He is affiliated to the Department of Medical Oncology, team leader (Integrated analysis of the dynamics of cancer) and co-Director of the Department Tumor Escape Resistance and Immunity at Cancer Research Center of Lyon (UMR INSERM 1052 CNRS 5286 – Centre Léon Bérard). Both his training as a postdoctoral and clinical fellow and his first faculty position as an Assistant Professor in the Department of Thoracic/Head and Neck Medical Oncology at the University of Texas MD Anderson Cancer Center, Houston, TX, led him to focus most of his own research in the head and neck field. We seek to understand the genetic evolutionary trajectories underlying premalignant lesions progression, the co-evolution between premalignant lesions and the immune micro-environment and to integrate phenotypic (expression profiles), genetic and immune profiling to improve risk assessment and to develop the rational for innovative interception and preventive strategies. We are also interested to understand the diversity and heterogeneity of established oral cancer before treatment initiation, under the selective pressure of systemic therapy and at the time of progressive disease to refine the current molecular classification, and test its relevance for improved patient stratification.

Biological diversity of oral leukoplakia, a potentially malignant disorder.

Oral leukoplakia is the most frequent oral potentially malignant disorder. Only a minority of patients will eventually develop oral cancer. We are facing multiple challenges. Patient management needs to be standardized. We lack prospectively validated and standardized biomarkers of risk to improve personalized risk-assessment. Finally, we need to develop innovative approaches to treat not only the actual “visible” oral lesion, but instead the whole field of cancerization. We will review some the approaches we are using to tackle some of those challenges, with a focus on the biological diversity. Its understanding may help improving risk-assessment and guide the development of rationally-based preventive strategies. Finally, we will present European initiatives that are meant to be inclusive to all stakeholders interested to join.

Hassan Bousbaa

Brief CV

Hassan Bousbaa is an Associate Professor of Cellular and Molecular Biology at the University Institute of Health Sciences (IUCS-CESPU). PhD in Life and Health Sciences (University of Paris-Est Créteil, France). His post-doc research focused on molecular genetics of mitosis, at the University of Porto, to unveil the mechanisms of cell division, and understand how errors in chromosome segregation arise and lead to genomic instability in cancer. He was part of the pioneering researchers that identified and characterized the genes involved in the mitotic checkpoint signaling, with great impact in the field. His current interests at UNIPRO include exploiting the clinical relevance of this information to identify novel cancer diagnostic and prognostic markers, as well as to develop novel therapeutic strategies to kill cancer cells or to increase their sensitivity to antimitotic agents. Hassan published >60 peer review publications (Scopus h-index: 21).

The spindle assembly checkpoint in oral cancer.

Abnormal chromosome number, or aneuploidy, is a common feature of human solid tumors, including oral cancer. Deregulated spindle assembly checkpoint (SAC) is thought as one of the mechanisms that drive aneuploidy. In normal cells, SAC prevents anaphase onset until all chromosomes are correctly aligned at the metaphase plate, thereby ensuring genomic stability. Significantly, the activity of this checkpoint is compromised in many cancers. While mutations are rather rare, many tumors show altered expression levels of SAC components. Genomic alterations such as aneuploidy indicate a high risk of oral cancer and cancer-related mortality, and the molecular basis of these alterations is largely unknown. Here, I will address the current understanding of the SAC molecular mechanisms, and discuss how this signaling circuitry can be exploited as drug targets to develop effective cancer therapies. The potential of SAC targeting as promising strategy against oral cancer will be highlighted.

Miguel Ángel González Moles

Brief CV

Degree in Medicine and Surgery, University of Granada, Spain

·   Specialty in Stomatology, University of Granada, Spain

·   Doctor of Medicine (PhD), University of Granada, Spain

·   Full Professor of Oral Medicine, University of Granada, Spain

·   Ex Head of Stomatology Department, University of Granada, Spain

·   Teaching Oral Medicine at the University of Granada since 1988. Author of 4 teaching innovation projects financed by the University of Granada,

·   Head of the research group CTS 392 (Junta de Andalucía), “Research in biopathology of oral squamous cell carcinoma”. Active group since 1995: Funded for his research by a total of 10 national competitive projects (FIS) and from the Autonomous Community of Andalusia.

·   Associate Editor of the journals Oral Diseases and Cancers

·   Member of the WHO Collaborating Center for Oral Cancer/Precancer to carry out an update of the terminology and the evaluation of the risk of malignant transformation of oral potentially malignant disorders (Workshop Glasgow, 2020; Head of the group: Saman Warnakulasuriya).

·   “Ranking of the World Scientists: World’s Top 2%” among the world’s most influential scientists, released by Stanford University.

·   Current Research lines: Study of molecular biomarkers of cancer prognosis, risk of development of oral premalignant fields and risk of multiple tumor development in patients with oral squamous cell carcinoma. Study of the potential for malignant transformation of oral lichen planus.

·   Director of 29 Doctoral Theses under the research lines mentioned.

·   External evaluator of research masters (MSc) in international universities.

·   Total publications: 178; H index: 44; 6,025 total citations (Google Scholar).

·   21 research awards.

Hallmarks of cancer: Reflections on oral carcinogenesis and prognosis.

Cancer hallmarks are a set of distinctive identity traits of cancer cells that were first proposed by Hanahan and Weinberg in 2000 and modified and completed by the authors later in 2011. Cancer cells develop these distinctive identities that reflect aspects that allow them to become malignant clones, metastasise and ultimately end a patient’s life if appropriate treatment measures are not put in place. Hanahan’s papers have received enormous attention since their publication with over 30,000 citations each. In our opinion, knowledge of these hallmarks is crucial as a prerequisite for the development of research in any type of carcinoma. Throughout our research activity, we realised that in many of these hallmarks there was a lack of research and evidence-based results in oral carcinoma. As this is an important tumour, both because of its frequency and its high mortality rate, we decided to carry out a scoping review of the publications on this aspect in order to detect evidence gaps and suggest future lines of research that are, in our opinion, essential for a better understanding of the biopathology of this tumour.