Made available in DSpace on 2014-12-17T14:13:27Z (GMT). No. of bitstreams: 1 OtavioJPN.pdf: 2556695 bytes, checksum: 1b00cc54688530c66184271da837d877 (MD5) Previous issue date: 2008-07-31 / The objectives of this clinical study was to evaluate the use of the toothpaste with fluoride and without fluoride and the daily tooth brushing are effective in the reversion of the dental enamel conditioned by acid. Another objective of this clinical study was to evaluate if the positioning of orthodontic accessories with glass ionomer cement helps in the reversion of the dental enamel conditioned by acid, when compared to composed resin. One hundred and twenty teeth were selected with indication of extraction by orthodontic reasons. The 30 volunteers were divided, randomly, in two groups. A group used toothpaste without fluoride and the other with it. The teeth of the sample were shuffled, in each volunteer. The teeth were conditioned by the 37% orthophosphoric acid. One of the conditioned teeth stayed in the mouth and suffered action of the abrasion for the tooth brushing, in another teeth a stainless steel mesh protection was positioned with glass ionomer cement, in another tooth the screen was glued with composed resin, in a fourth tooth (the control) was only conditioned after the extractions, 60 days later. All the teeth were appraised through DIAGNOdent, MEVA and EDS. In the obtained data it was possible to observe that there were not statistic significant differences in any comparison, even in the group that did not have access to the fluoride in the toothpaste as in the other that had. According with the used methodology, it was possible to observe too that there was not statistic significant differences in any comparison, even in the group that had the stainless steel mesh positioned with glass ionomer cement as in the group that the stainless steel mesh was positioned with composed resin. However, it was observed that there was an improvement in the topography of the enamel in all the teeth. The accomplishment of this study was facilitated due to the participation of the researchers' of the health area (dentistry), materials engineer, physics and chemistry. The researchers were originating from the Federal University of Rio Grande do Norte and of the University of Queensland, in Australia. This interdisciplinary group was decisive in the accomplishment of the study. It can be concluded that the enamel tends to return to its initial aspect, even if the patient does not have access to fluoride. That is probably due the action of the abrasion for the tooth brushing and mastication. In spite of it not being significant, it is suggested that the conditioned enamel was more resistant to the abrasion in the group that had access to fluoride. It was also possible to conclude that the fluoride liberated by the glass ionomer was not enough to provide a significant difference in the enamel conditioned by the acid, when compared with the composed resin, even in the group that did not use fluoride in the toothpaste as in the group that used / O objetivo deste estudo foi de avaliar o uso do dentifr?cio com fl?or e sem fl?or e a escova??o di?ria na revers?o do esmalte dent?rio condicionado pelo ?cido. Outro objetivo foi de avaliar se a colagem de acess?rios ortod?nticos com ion?mero de vidro auxilia na revers?o do esmalte dent?rio condicionado pelo ?cido. Foram selecionados 120 dentes com extra??o indicada de 30 volunt?rios que foram divididos, leatoriamente, em dois grupos. Um grupo utilizou dentifr?cio sem fl?or e o outro com fl?or. Os dentes foram condicionados pelo ?cido. Um dos dentes condicionados permaneceu na boca e sofreu a??o da abras?o pela escova??o, noutro foi colada uma tela de prote??o com ion?mero de vidro, noutro a tela foi colada com resina composta, num quarto dente (controle) s? foi condicionado ap?s as extra??es, 60 dias depois. Todos os dentes foram avaliados atrav?s do DIAGNOdent, MEVA e EDS. Nos resultados obtidos foi poss?vel observar que n?o houve diferen?a estatisticamente significativa em nenhuma compara??o, tanto no grupo que n?o teve acesso ao fl?or no dentifr?cio como no que teve. Por?m, foi observado que houve uma melhora na topografia do esmalte em todos os dentes. A realiza??o desse trabalho foi facilitada devido ? participa??o de pesquisadores das ?reas da sa?de (odontologia), engenharia dos materiais, f?sica e qu?mica. Os pesquisadores foram oriundos da Universidade Federal do Rio Grande do Norte e da University of Queensland, na Austr?lia. Essa multidisciplinaridade foi decisiva na realiza??o desse estudo. Com esse estudo pode-se concluir que o esmalte tende a retornar o seu aspecto inicial, mesmo que o paciente n?o tenha acesso ao fl?or. Isso se deve provavelmente a a??o da abras?o pela escova??o e mastiga??o. Tamb?m foi poss?vel concluir que o fl?or liberado pelo ion?mero de vidro da colagem do acess?rio ortod?ntico n?o foi suficiente para proporcionar uma diferen?a significativa no esmalte condicionado pelo ?cido. Tanto no grupo que n?o utilizou fl?or no dentifr?cio como no grupo que usou

Linha de pesquisa: Epidemiologia e controle das doen?as bucais. / Submitted by Jos? Henrique Henrique (jose.neves@ufvjm.edu.br) on 2018-03-12T22:27:53Z No. of bitstreams: 1 izabella_barbosa_fernandes.pdf: 1966332 bytes, checksum: 66932f9b7cbb62d762a7b8e0b68dd7a1 (MD5) / Made available in DSpace on 2018-03-12T22:27:53Z (GMT). No. of bitstreams: 1 izabella_barbosa_fernandes.pdf: 1966332 bytes, checksum: 66932f9b7cbb62d762a7b8e0b68dd7a1 (MD5) Previous issue date: 2017 / O objetivo desse estudo de coorte foi avaliar o risco de fatores cl?nicos e socioambientais dos primeiros anos de vida da crian?a sobre: (1) a progress?o da c?rie dent?ria; (2) a presen?a de dor de dente; (3) a ocorr?ncia de m? oclus?o; (4) o impacto na qualidade de vida relacionada ? sa?de bucal de crian?as pr?-escolares e suas fam?lias. Este estudo foi realizado com 151 pares de m?es e crian?as que participaram de um estudo transversal realizado no ano de 2014 na cidade de Diamantina, Minas Gerais. Durante o baseline (2014) essas crian?as apresentavam de 1 a 3 anos de idade e foram avaliadas clinicamente para verificar a presen?a de c?rie dent?ria por meio dos crit?rios do Sistema Internacional de Avalia??o e Detec??o de C?rie Dent?ria (ICDAS) de placa dent?ria vis?vel, de m? oclus?o e de traumatismos dent?rios. As m?es tamb?m foram avaliadas clinicamente para verificar a presen?a de c?rie dent?ria por meio dos crit?rios da Organiza??o Mundial de Sa?de. Foram aplicados tr?s question?rios ?s m?es sob a forma de entrevista: um question?rio para avalia??o da qualidade de vida relacionada ? sa?de bucal, a vers?o brasileira do Early Childhood Oral Health Impact Scale (B-ECOHIS), o Dental Anxiety Scale (DAS) e um question?rio que abordava aspectos socioambientais da fam?lia al?m de informa??es relativas ?s crian?as e seus h?bitos. Todas as m?es foram orientadas acerca das condi??es bucais de seus filhos e as crian?as foram encaminhadas para atendimento odontol?gico. Ap?s tr?s anos (T1) as crian?as foram reavaliadas clinicamente e as m?es responderam novamente ao B-ECOHIS, ao DAS, al?m de responderem a um question?rio para avalia??o de dor de dente, a vers?o brasileira do Dental Discomfort Questionnaire (DDQ-B). A an?lise de dados foi realizada atrav?s do Statistical Package for the Social Sciences (SPSS) vers?o 22.0, e incluiu a descri??o de frequ?ncia das vari?veis, teste qui-quadrado, teste Wilcoxon e regress?o hier?rquica de Poisson. Crian?as que possu?am pelo menos um dente com c?rie cavitada no baseline, apresentaram maior risco de progress?o de outras les?es cariosas. Foram fatores de risco para a ocorr?ncia de dor de dente em T1, a presen?a de c?rie dent?ria cavitada e a maior aglomera??o familiar no baseline. A presen?a, no baseline, de c?rie dent?ria cavitada e do h?bito de suc??o de dedo foram fatores determinantes da presen?a de m? oclus?o em T1. Incremento de c?rie severa, tratamento odontol?gico e escore do B-ECOHIS no baseline foram associados ? piora na qualidade de vida. Conclui-se que c?rie dent?ria, suc??o de dedo e maior aglomera??o familiar s?o fatores de risco para piores resultados em sa?de bucal na idade pr?-escolar. Incremento de c?rie severa, aus?ncia de tratamento dent?rio e menor escore do B-ECOHIS no baseline foram fatores de risco para a piora na qualidade de vida. / Tese (Doutorado) ? Programa de P?s-Gradua??o em Odontologia, Universidade Federal dos Vales do Jequitinhonha e Mucuri, 2017. / The aim of this cohort study was to evaluate the risk of clinical and socioenvironmental variables in the first years of the child's life: (1) in the progression of dental caries; (2) in the presence of toothache; (3) in the occurrence of malocclusion; (4) in the impact on quality of life related to oral health of preschool children and their families. This study was conducted with 151 pairs of mothers and children who participated in a cross-sectional study conducted in the city of Diamantina, Minas Gerais, in 2014. During the baseline (2014), these children presented 1 to 3-years-old and were clinically evaluated to verify the presence of dental caries using the International Dental Caries Assessment and Detection System (ICDAS) for dental plaque, malocclusion and dental trauma. Mothers were also evaluated clinically to verify the presence of dental caries using World Health Organization criteria. Three questionnaires were applied to the mothers in the form of interviews: a questionnaire to assess the quality of life related to oral health, the Brazilian version of the Early Childhood Oral Health Impact Scale (B-ECOHIS), the Dental Anxiety Scale (DAS) and a questionnaire that addressed socioenvironmental and demographic aspects of the family, as well as information about the children and their habits. All mothers were instructed about the oral conditions of their children and the children were referred to dental care. After three years (T1), the children were clinically re-evaluated and the mothers responded again to the B-ECOHIS, the DAS, and answered a questionnaire for assessing tooth pain, the Brazilian version of the Dental Discomfort Questionnaire (DDQ-B). Data analysis was performed using the Statistical Package for Social Sciences (SPSS) version 22.0, and included the frequency description of the variables, chi-square test, and Poisson hierarchical regression. Children who had at least one tooth with caries cavity in the baseline presented a higher risk of progression of other carious lesions. The presence of cavitary tooth decay and the greater familial agglomeration in the baseline were risk factors for the occurrence of tooth pain in T1. The presence, in the baseline, of cavitary tooth decay and finger suction habit were factors determining the presence of malocclusion in T1.The incidence of severe caries, absence of dental treatment and higher score of B-ECOHIS at the baseline were associated with worsening quality of life. In conclusion, tooth decay, finger suction, greater family agglomeration and the impact on the quality of life in the first years of the child's life, are risk factors for worse oral health outcomes at preschool age. The incidence of severe caries, the absence of dental treatment, and a lower score on B-ECOHIS were risk factors to worsen the quality of life.

Made available in DSpace on 2014-12-17T15:30:52Z (GMT). No. of bitstreams: 1 ArcelinoFN.pdf: 1789959 bytes, checksum: 7868add86eb8184ae325d8e244224b90 (MD5) Previous issue date: 2009-02-04 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / The maintenance of masticatory function is especially important for patients who wear complete dentures due to the limitations of this type of prosthesis. Thus, the bilateral balanced occlusion (BBO) is used to achieve, besides other advantages, greater masticatory efficiency. However, analyzing critically the literature, it is observed that there is not enough scientific evidence that support the BBO as the most appropriate occlusal concept in complete dentures. This way, the purpose of the present study was to verify if complete dentures wearers with BBO present better masticatory efficiency and capacity than those with canine guidance (CG). A double-blind controlled crossover clinical trial was conducted. The sample was made of 24 completely edentulous patients. The subjects wore sets of complete dentures with both occlusal concepts for equal periods of 3 months. Objective data were collected through the masticatory efficiency test, performed by the colorimetric method, in which capsules of a synthetic material enclosing fuchsine- containing granules were used. Subjective data were recorded by patient?s ratings of their chewing function, which is the masticatory ability. No significant statistical difference was found for masticatory efficiency (p=0,0952) and masticatory ability (x2=0,5711/ p=0,4498) between the two occlusal concepts studied, as well as there was no correlation between these two variables (p=0,2985). Based on these results, it seems reasonable to use CG for the setup of complete dentures, since it is an easier and quicker technical procedure, until that future researches can come to complement this question / A manuten??o da fun??o mastigat?ria tem import?ncia especial em pacientes portadores de pr?tese total devido ?s limita??es inerentes a esse tipo de pr?tese. Nesse contexto, a oclus?o balanceada bilateral (OBB) ? empregada com o intuito de obter-se, entre outras vantagens, uma maior efici?ncia mastigat?ria. Entretanto, analisando-se a literatura criticamente, observa-se que n?o existem evid?ncias cient?ficas suficientes que suportem a aplica??o da OBB como conceito oclusal ideal em pr?tese total. Assim, o presente trabalho teve o objetivo de verificar se pacientes portadores de pr?tese total dupla com OBB apresentam maior efici?ncia e capacidade mastigat?ria que aqueles com desoclus?o com guia canino (DGC). Com esse intuito, realizou-se um ensaio cl?nico controlado duplo-cego do tipo crossover. A amostra foi composta de 24 pacientes portadores de pr?tese total dupla, onde todos fizeram uso de ambos os conceitos oclusais por per?odos iguais de 3 meses. A fun??o mastigat?ria foi avaliada clinicamente atrav?s da efici?ncia mastigat?ria, onde se empregou o m?todo colorim?trico com o uso de c?psulas mastigat?rias, e pela capacidade mastigat?ria, relativa ao grau de satisfa??o. N?o se encontrou diferen?a estat?stica significativa para a efici?ncia (p=0,0952) e a capacidade mastigat?ria (x2 =0,5711/ p=0,4498) entre os dois grupos estudados, bem como n?o foi observada nenhuma rela??o entre essas duas vari?veis (p=0,2985). Dessa forma, parece sensato o emprego da DGC nos movimentos exc?ntricos em pr?tese total, por ser este um procedimento mais simples e r?pido, at? que futuras pesquisas venham a complementar qual o conceito oclusal ideal em pr?tese total

Made available in DSpace on 2014-12-17T15:32:31Z (GMT). No. of bitstreams: 1 GustavoPG_tese.pdf: 864388 bytes, checksum: f88b048184bdf52b12d2e542ee44707e (MD5) Previous issue date: 2005-08-19 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / Uma das grandes controv?rsias encontradas na literatura cient?fica consiste no estabelecimento de crit?rios para distin??o entre um fol?culo pericoron?rio espessado e um cisto dent?gero incipiente. O objetivo do presente estudo consistiu em avaliar a express?o imuno-histoqu?mica das integrinas &#945;2&#946;1, &#945;3&#946;1e &#945;5&#946;1 nas referidas entidades, onde foram selecionados 23 casos de fol?culos pericoron?rios espessados e 21casos de cistos dent?geros incipientes. Analisou-se a presen?a ou aus?ncia de express?o destas integrinas nas ilhotas de epit?lio odontog?nico e nos epit?lios constituintes de cada entidade, enfatizando a localiza??o, intensidade e padr?o de distribui??o para compara??o entre as mesmas. Todas as integrinas apresentaram marca??o nos casos analisados. Foi observada uma diferen?a estatisticamente significativa (p<0,0001) para a integrina &#945;2&#946;1 entre as duas entidades, apresentando os cistos dent?geros incipientes uma marca??o mais intensa. Tamb?m se verificou diferen?a entre a camada basal e a suprabasal no epit?lio c?stico (p<0,0034). A integrina &#945;3&#946;1 apresentou uma diferen?a estatisticamente significativa (p<0,013) entre as duas entidades, com os cistos dent?geros incipientes apresentando uma tend?ncia de marca??o intensa. Em rela??o a integrina &#945;5&#946;1, n?o se observou diferen?a de express?o entre os dois grupos, ressaltando-se entretanto a intensa marca??o desta integrina na maioria dos casos aqui avaliados, refor?ando o entendimento da participa??o da mesma na diferencia??o celular. Concluiu-se portanto que a maior express?o da integrina &#945;2&#946;1 em cistos dent?geros incipientes, bem como nas c?lulas da camada basal do epit?lio deste cisto, pode estar relacionada com a maior atividade proliferativa das referidas c?lulas, enquanto que a tend?ncia de express?o mais intensa da integrina &#945;3&#946;1 nos cistos dent?geros incipientes se deva ? participa??o desta integrina na organiza??o da estratifica??o epitelial bem como na expans?o c?stica por poss?vel ativa??o de metaloproteinases. Adicionalmente, verificou-se que estes achados corroboram a possibilidade de distin??o histopatol?gica entre um fol?culo pericoron?rio espessado e um cisto dent?gero incipiente, onde a metaplasia escamosa do epit?lio reduzido do ?rg?o do esmalte para um epit?lio pavimentoso estratificado seria o primeiro sinal vis?vel de transforma??o c?stica

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-01-13T14:15:30Z No. of bitstreams: 1 RenatoDuarteDeCarvalho_DISSERT.pdf: 5222372 bytes, checksum: 32cdf2eee5f3ae32e6c46240d98be651 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-01-26T13:02:40Z (GMT) No. of bitstreams: 1 RenatoDuarteDeCarvalho_DISSERT.pdf: 5222372 bytes, checksum: 32cdf2eee5f3ae32e6c46240d98be651 (MD5) / Made available in DSpace on 2017-01-26T13:02:40Z (GMT). No. of bitstreams: 1 RenatoDuarteDeCarvalho_DISSERT.pdf: 5222372 bytes, checksum: 32cdf2eee5f3ae32e6c46240d98be651 (MD5) Previous issue date: 2016-08-18 / OBJETIVO: O objetivo deste estudo foi determinar, atrav?s de diferentes m?todos, o bi?tipo periodontal de dentes e espa?os prot?ticos em pacientes pr?vios ? reabilita??o unit?ria com implantes osseointegrados e carga imediata em ?reas est?ticas. METODOLOGIA: trata-se de um estudo de diagn?stico, por meio da avalia??o periodontal dos pacientes previamente ao tratamento com pr?teses unit?rias sobre implantes osseointegrados. Uma amostra inicial de 34 pacientes foi considerada. Foram inclu?dos no estudo pacientes com aus?ncias unit?rias em ?rea est?tica e sa?de periodontal. Foram exclu?dos os pacientes com m?ltiplas aus?ncias candidatos a reabilita??o com pr?tese unit?ria em regi?o n?o est?tica. RESULTADOS: Foram encontradas correla??es estatisticamente significativas entre espessura horizontal da mucosa no espa?o prot?tico e espessura vertical da mucosa no espa?o prot?tico (p<0,001) e espessura horizontal da mucosa nos dentes adjacentes ao espa?o prot?tico e espessura horizontal no espa?o prot?tico (p=0,001). N?o foram encontradas correla??es entre as espessuras horizontal/vertical e as demais vari?veis de interesse: transpar?ncia ? sondagem, g?nero, altura e largura das coroas e papilas, profundidade de sondagem vestibular e raz?o altura/largura de coroas e papilas. A an?lise de conglomerados (clusters) resultou em dois grupos bem definidos, G1 (bi?tipo espesso) e G2 (bi?tipo fino) que, quando analisados em rela??o as vari?veis acima, apresentou diferen?as significativas para transpar?ncia a sondagem (p=0,04), espessura vertical do espa?o prot?tico (p<0,001), espessura horizontal dos dentes adjacentes (p<0,001), profundidade de sondagem vestibular (p=0,05) e raz?o altura/largura das papilas dos dentes adjacentes (p=0,02). O teste de transpar?ncia ? sondagem obteve 77,8% de sensibilidade e 56,3% de especificidade, com acur?cia geral de 67,7%. CONCLUS?O: Os bi?tipos periodontais s?o classific?veis, apresentam distintos par?metros morfom?tricos e t?m como principais influenciadores espessura gengival horizontal, espessura gengival vertical e transpar?ncia ? sondagem vestibular para classifica??o. O m?todo da transpar?ncia ? sondagem foi eficaz no diagn?stico dos tipos de bi?tipos periodontais avaliados. / The aim of this study was to determine, by analyzing different methods of determination, the periodontal biotype of teeth and prosthetic spaces in patients prior to the unitary rehabilitation with dental implants, including anterior and posterior regions. and immediate loading in aesthetic areas. This is a diagnostic study through evaluation of periodontal patients before treatment unit prosthetic dental implants. An initial sample of 34 patients was considered. The study included patients with unit absences in cosmetic area and periodontal health. They excluded patients with multiple absences candidates for rehabilitation with unitary prosthesis in no aesthetic region not exposed to smile. The probing depth, transparency on probing, the presence of recession, the sizes of crowns and buds adjacent to the prosthetic space, the horizontal gingival thickness and the horizontal and vertical thickness of keratinized tissue were evaluated parameters. Significant correlations were found between horizontal mucosa thickness for the prosthetic vertical space and mucosal thickness of the prosthetic area (p <0.001) and the horizontal thickness of the mucosa adjacent to the prosthetic teeth horizontal space and thick space for the prosthetic (p = 0.001). There were no correlations between the horizontal / vertical thickness and other variables of interest: the transparency survey, gender, height and width of the crowns and buds, depth vestibular probing and right height / width of crowns and buds. The cluster analysis (clusters) cluster resulted in two well defined groups, G1 (thick biotype) and G2 (thin biotype) which, when analyzed for the above variables, showed significant differences for transparency survey (p = 0.04) vertical thickness of the prosthetic area (p <0.001), horizontal thickness of the adjacent teeth (p <0.001), buccal probing depth (p = 0.05) and ratio height / width of the papillae of adjacent teeth (p = 0.02 ). The poll transparency test achieved 77.8% sensitivity and 56.3% specificity with overall accuracy of 67.7%. Periodontal biotypes are classifiable, have different morphometric parameters and have as key influencers horizontal gingival thickness, vertical gingival thickness and transparency vestibular probing for classification. The method of transparency on probing was effective in diagnosing types evaluated periodontal biotypes.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-07-17T13:12:44Z No. of bitstreams: 1 FernandaGinaniAntunes_TESE.pdf: 2184683 bytes, checksum: 53f3cc6dc1251b2dcdc05b91678ae4d3 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-07-18T15:34:49Z (GMT) No. of bitstreams: 1 FernandaGinaniAntunes_TESE.pdf: 2184683 bytes, checksum: 53f3cc6dc1251b2dcdc05b91678ae4d3 (MD5) / Made available in DSpace on 2017-07-18T15:34:49Z (GMT). No. of bitstreams: 1 FernandaGinaniAntunes_TESE.pdf: 2184683 bytes, checksum: 53f3cc6dc1251b2dcdc05b91678ae4d3 (MD5) Previous issue date: 2017-02-23 / O laser de baixa intensidade (LBI) tem apresentado resultados positivos na prolifera??o de diversos tipos celulares in vitro. A primeira parte do trabalho avaliou o efeito do LBI na prolifera??o e viabilidade de c?lulas-tronco da polpa de dentes dec?duos humanos esfoliados (SHED). As c?lulas foram irradiadas ou n?o (controle) com um laser diodo InGaAlP (660 nm, 30 mW, modo de a??o cont?nuo) usando duas diferentes doses (0,5 J/cm2 por 16 segundos e 1,0 J/cm2 por 33 segundos) e os tr?s grupos foram estudados nos intervalos de 0, 24, 48 e 72 h. Foi observado que a dose de 1,0 J/cm2 promoveu um aumento na prolifera??o celular nos intervalos de 48 e 72 h quando comparada ao grupo controle e ? dose de 0,5 J/cm2 e a viabilidade celular n?o foi afetada pela irradia??o ao longo do experimento. Em conjunto, os dados mostraram que os par?metros do LBI utilizados (660 nm, 30 mW, 1,0 J/cm2) promoveram prolifera??o das SHEDs e mantiveram a sua viabilidade. A partir destes resultados favor?veis, a segunda parte do trabalho avaliou o efeito do LBI com os mesmos par?metros na prolifera??o de SHEDs cultivadas sobre arcabou?os nanofibrosos de PLA confeccionados pela t?cnica de eletrofia??o. Este procedimento permite a obten??o de arcabou?os tridimensionais que simulam a matriz extracelular a partir de um biomaterial com propriedades f?sicas favor?veis e baixo custo. Tr?s grupos experimentais (G1 ? n?o irradiado; G2 ? irradiado com 0,5 J/cm2; G3 ? irradiado com 1,0 J/cm2) foram analisados nos intervalos de 24, 48 e 72 h. Os resultados indicaram que o PLA n?o ? citot?xico para as SHEDs e que os grupos submetidos ? laserterapia tiveram maior prolifera??o celular quando comparados com o grupo controle n?o irradiado. Com base nos achados, evidenciou-se que as nanofibras de PLA s?o arcabou?os favor?veis para o cultivo de SHEDs e que a laserterapia estimulou a prolifera??o quando aplicada nas c?lulas cultivadas sobre este arcabou?o. Com base nos dados gerais obtidos, conclui-se que a laserterapia nos par?metros avaliados apresenta efeitos bioestimulat?rios nas SHEDs cultivadas tanto na superf?cie padr?o (pl?stico da placa de cultivo) quanto sobre arcabou?os nanoestruturados de PLA. / The low-level laser therapy (LLLT) has been shown positive results in the in vitro proliferation of several cell types. The first part of the study evaluated the effect of LLLT on the proliferation and viability of stem cells from human exfoliated deciduous teeth (SHED).Cells were irradiated or not (control) with an InGaAlP diode laser (660 nm, 30 mW, continuous action mode) using two different doses (0.5 J/cm2 for 16 seconds and 1.0 J/cm2 for 33 seconds) and the three groups were analyzed at the intervals of 0, 24, 48 and 72 h.It was observed that the dose of 1.0 J/cm2 promoted an increase in cell proliferation at the 48 and 72 h intervals when compared to the control group and the dose of 0.5 J/cm2, and that cell viability was not affected by irradiation throughout the experiment. Taken together, the data showed that the LLLT parameters (660 nm, 30 mW, 1.0 J/cm2) promoted proliferation of SHEDs and maintained their viability. Based on these favorable results, the second part of the study evaluated the effect of LLLT with the same parameters on the proliferation of SHEDs cultured on PLA nanofibrous scaffolds obtained by electrospinning. This procedure allows obtaining three-dimensional scaffolds that mimic the extracellular matrix from a biomaterial with favorable physical properties and low cost.Three experimental groups (G1 - non-irradiated; G2 - irradiated with 0.5 J/cm2; G3 - irradiated with 1.0 J/cm2) were analyzed at 24, 48 and 72 h. The results indicated that PLA is not cytotoxic to SHEDs and that the groups submitted to laser therapy had higher cell growth when compared to the nonirradiated control group. Based on these findings, it was shown that PLA nanofibers are favorable scaffolds for the cultivation of SHEDs and that laser therapy stimulated the proliferation when applied to the cells cultured on this scaffold. Based on the general data obtained, it is concluded that the laser therapy in the evaluated parameters has biostimulatory effects on the proliferation of SHEDs on both the standard surface (plastic of the culture plate) and on nanostructured PLA scaffolds.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-10-05T00:11:28Z No. of bitstreams: 1 ItaniellyDantasSilveiraCruz_DISSERT.pdf: 2442849 bytes, checksum: 02e55bdcb8191be6836bcbfa7df46f9c (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-10-16T23:01:44Z (GMT) No. of bitstreams: 1 ItaniellyDantasSilveiraCruz_DISSERT.pdf: 2442849 bytes, checksum: 02e55bdcb8191be6836bcbfa7df46f9c (MD5) / Made available in DSpace on 2017-10-16T23:01:44Z (GMT). No. of bitstreams: 1 ItaniellyDantasSilveiraCruz_DISSERT.pdf: 2442849 bytes, checksum: 02e55bdcb8191be6836bcbfa7df46f9c (MD5) Previous issue date: 2017-07-25 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior (CAPES) / Objetivo: Analisar o efeito de diferentes protocolos de fotoativa??o na resist?ncia de uni?o ao cisalhamento (RUC) de br?quetes met?licos colados em esmalte e no grau de convers?o (GC) de uma resina ortod?ntica utilizando tr?s aparelhos fotoativadores. Metodologia: 230 coroas de incisivos bovinos foram distribu?das aleatoriamente em 23 grupos (n=10). Ap?s ser realizado o tratamento de superf?cie com ?cido fosf?rico (15 segundos) e Primer Transbond XT (3M Unitek), br?quetes met?licos foram colados ao esmalte com resina Transbond XT (3M Unitek) utilizando 23 protocolos de fotoativa??o de acordo com os fatores ?aparelho fotoativador? (FlashMax P4 ? RMO, Valo Cordless ? Ultradent ou Radii-Cal ? SDI), ?faces fotoativadas? (centro/vestibular; mesial, distal, cervical e incisal; mesial e distal ou cervical e incisal) e ?tempo de fotoativa??o? (2, 3, 4, 6, 20 ou 40 segundos). O ensaio de cisalhamento (100KgF, 1mm/min) foi realizado ap?s o armazenamento das amostras por 4 meses (?gua destilada, 37?C). Utilizando os mesmos protocolos de fotoativa??o, 230 discos de resina (0,1 mm de espessura e 5 mm de di?metro, em m?dia) foram confeccionados para an?lise do GC. Os dados da RUC (MPa) e do GC (%) foram avaliados descritivamente e atrav?s do teste T de Student, da ANOVA one way e do teste de Tukey. As falhas de uni?o foram classificadas de acordo com o ?ndice Remanescente Adesivo (IRA), analisadas descritivamente e atrav?s do teste de Kruskal-Wallis. Resultados: De todos os 23 protocolos, apenas 5 apresentaram valores de RUC clinicamente aceitos de acordo com a literatura. No que diz respeito aos fatores ?faces fotoativadas? e ?tempo de fotoativa??o?, os protocolos do Valo Cordless foram os ?nicos que apresentaram resultados quanto ? RUC estatisticamente semelhantes (p=0,230 e p=0,093, respectivamente). Das compara??es que apresentaram diferen?a estatisticamente significativa (p?0,05) quanto ao fator ?tempo de fotoativa??o? de acordo com a RUC, 66,6% correspondem aos protocolos onde apenas a face central do br?quete foi fotoativada. Ao comparar os grupos onde apenas duas faces foram fotoativadas, aqueles em que o par de faces correspondeu ? mesial e ? distal foram os que resultaram maiores valores de RUC. Quanto ao GC, tendo em vista o fator ?faces fotoativadas?, apenas os resultados dos grupos do FlashMax P4 foram estatisticamente diferentes (p?0,05). O Valo Cordless foi o ?nico aparelho no qual o fator ?tempo de fotoativa??o? n?o afetou de forma estatisticamente significa os valores do GC (p=0,968). E a maioria (66,6%) dos valores mais elevados do GC quando apenas duas faces foram fotoativadas correspondeu ?queles protocolos nos quais tais faces foram a mesial e a distal. Em rela??o ao IRA, houve diferen?a estatisticamente significativa entre os escores (p=0,000), sendo que o escore 2 foi o mais observado (52,6%). Conclus?o: A RUC dos br?quetes met?licos colados ao esmalte e o GC da Transbond XT podem apresentar diferen?as estatisticamente significativas a depender do aparelho fotoativador selecionado e do protocolo de colagem utilizado pelo ortodontista. E sup?e-se que a for?a adesiva entre a resina e o esmalte dent?rio ? maior do que aquela entre o br?quete e a Transbond XT. / Objective: To analyze the effect of different photoactivation protocols on shear bond strength (SBS) of metallic brackets bonded to enamel and the degree of conversion (DC) of an orthodontic resin using three photoactivating devices. Methodology: 230 crowns of bovine incisors were randomly distributed in 23 groups (n = 10). After the surface treatment with phosphoric acid (15 seconds) and Primer Transbond XT (3M Unitek), metal brackets were bonded to the enamel with Transbond XT resin (3M Unitek) using 23 photoactivation protocols according to the factors "photoactivator" (FlashMax P4 ? RMO, Valo Cordless ? Ultradent or Radii-Cal ? SDI), "photoactivated faces" (center/vestibular; mesial, distal, cervical and incisal; mesial and distal or cervical and incisal) and "photoactivation time" (2, 3, 4, 6, 20 or 40 seconds). The shear test (100KgF, 1mm/min) was performed after storage of the samples for 4 months (distilled water, 37?C). Using the same photoactivation protocols, 230 resin discs (0,1 mm thick and 5 mm diameter, on average) were made for DC analysis. The SBS (MPa) and DC (%) data were evaluated descriptively and through Student's T-test, one-way ANOVA and the Tukey test. The union failures were classified according to the Adhesive Remnant Index (ARI), analyzed descriptively and through the Kruskal-Wallis test. Results: Of all 23 protocols, only 5 presented clinically accepted SBS values according to the literature. Regarding the factors "photoactivated faces" and "photoactivation time", the Valo Cordless protocols were the only ones that presented statistically similar SBS results (p=0,230 and p=0,093, respectively). Of the comparisons that presented a statistically significant difference (p?0,05) regarding the factor "time of photoactivation" according to SBS, 66,6% corresponded to the protocols where only the central face of the bracket was photoactivated. When comparing the groups where only two faces were photoactivated, those in which the pair of faces corresponded to the mesial and the distal were the ones that resulted in higher SBS values. Regarding the CG, considering the "photoactivated faces" factor, only the results of the FlashMax P4 groups were statistically different (p?0,05). The Valo Cordless was the only device in which the factor "time of photoactivation" didn?t affect statistically means the values of the DC (p=0,968). And the majority (66,6%) of the highest DC values when only two faces were photoactivated corresponded to those protocols in which such faces were mesial and distal. Regarding ARI, there was a statistically significant difference between the scores (p=0,000), and the score 2 was the most observed (52,6%). Conclusion: The SBS of the metal brackets bonded to the enamel and the DC of the Transbond XT resin may present statistically significant differences depending on the selected photoactivating device and the bonding protocol used by the orthodontist. And it?s assumed that the adhesive force between the resin and the dental enamel is greater than that between the bracket and the Transbond XT.

Le tubule proximal participe à la diurèse en modifiant la composition de l'ultrafiltrat glomérulaire. Grâce à de nombreux transports transépithéliaux, il le glucose, les acides aminés et les protéines de bas poids moléculaires, ainsi que 80 % des ions HPO42- ou HCO3-, 60 % des ions Na+, Cl-, K+, Ca2+, 75 % de l’eau et 30 % des ions Mg2+ ultrafiltrés.Durant ma thèse, j'ai étudié les rôles physiologiques et physiopathologiques de deux protéines de transport exprimées dans le tubule proximal.Dans le cadre de ma première étude, j'ai évalué in vivo la fonction rénale de souris n'exprimant pas une protéine appelée Kir4.2, dont le rôle est inconnu. Nos résultats montrent que Kir4.2, associée à Kir5.1, forme un canal potassique basolatéral Kir4.2/Kir5.1 dans le tubule proximal. L'absence de Kir4.2 provoque chez la souris une acidose tubulaire proximale isolée, consécutive à une ammoniogénèse altérée. De fait, la perte de fonctionnalité de Kir4.2 pourrait être à l'origine d'acidoses tubulaires proximales isolées familiales idiopathiques.Dans le cadre de ma seconde étude, j'ai analysé in vitro la fonctionnalité d'un mutant pathogène de l'échangeur 2Cl-/H+ ClC-5 impliqué dans la maladie de Dent. Cette maladie, caractérisée par une protéinurie de bas poids moléculaire associées à divers troubles du tubule proximal, serait liée à un défaut d'acidification des endosomes précoces par ClC-5. Toutefois, le mutant de ClC-5 que nous avons étudié, converti en canal chlorure, acidifie autant les endosomes précoces que le ClC-5 sauvage. Surprenants, ces résultats suggèrent que la maladie de Dent puisse être causée par un défaut d'accumulation d'ions chlorure dans l'endosome. / The proximal tubule is involved in diuresis by modifying the content of the glomerular ultrafiltrate. Using a variety of transepithelial transports systems, it reabsorbs all ultrafiltrated glucose, amino-acids and low molecular weight proteins, as well as 80% of HPO42- and HCO3- ions, about 60% of Na+, Cl-, K+, and Ca2+ ions, 75% of water and 30% of Mg2+.During this thesis, I determined the physiological and physiopathological roles of two transport proteins present in proximal tubule. Firstly, I evaluated the renal function of mice invalidated for the Kir4.2 protein, whose role was undetermined. Our results show that Kir4.2, in association with Kir5.1, form a Kir4.2/Kir5.1 potassium channel at the basolateral membrane of proximal tubular cells. Furthermore, Kir4.2-null mice exhibit a reduced ammoniagenesis leading to an isolated proximal renal tubular acidosis. This study provides the gene encoding Kir4.2 as a candidate gene for the yet unexplained autosomal dominant isolated proximal renal tubular acidosis.Secondly, I evaluated in vitro the functional consequences of a pathogenic mutation of the 2Cl-/H+ exchanger ClC-5, involved in Dent’s disease. This disease, characterized by a low-molecular-weigth-proteinuria in the context of a general proximal tubule dysfunction, is currently thought to be due to an acidification defect of early endosomes linked to a loss of function of ClC-5. Surprisingly, our results show that ClC-5, converted into a chloride channel by this mutation, indeed acidifies the early endosomes as well as the ClC-5 wild-type. Thus, Dent’s disease may originate from a defect in the accumulation of chloride ions into the early endosomes.

Toutes altérations génétiques ou environnementales survenant lors du développement craniofacial et de l’odontogenèse peut aboutir à une fente orale et/ou à des anomalies dentaires. Un des syndromes les plus courants comprenant une fente orale est le syndrome de van der Woude (VWS) / des ptérygiums poplités (PPS) causé par des mutations du gène IRF6. Nous avons séquencé IRF6 dans 16 familles VWS et 2 familles PPS et analysé le phénotype dentaire des patients avec une mutation identifiée. Les individus atteints présentaient des fentes (76%), des dépressions de la lèvre inférieure (86%), des agénésies dentaires (68%) ainsi que des anomalies de morphologie dentaire (58%), telles que des dents fusionnées ou porteuses de cuspides supplémentaires, démontrant que la fréquence élevée des anomalies dentaires constatées chez les patients VWS/PPS avec une mutation IRF6 pourrait se révéler utile dans la pose du diagnostic, dans la mesure où les dépressions de la lèvre inférieure ne sont pas toujours présentes. Malgré le nombre considérable de gènes identifiés dans les fentes orales et/ou anomalies dentaires, la cause génétique de bon nombre de cas isolés reste sans réponse. Partir de patients syndromiques avec fente, porteurs d’anomalies chromosomiques, a permis la découverte de nouveaux gènes associés aux fentes : HDAC4, HIPK2, RBFOX1, SWSWAP et MMP17. En plus des mutations touchant la partie codante des gènes et des variants introniques prédisposants, l’altération d’éléments régulateurs distants peut aussi conduire à l’apparition de fentes, comme nous le montrons dans ce travail avec l’altération d’éléments régulateurs de SOX9. D’autre part, le tri minutieux de patients syndromiques basé sur un phénotypage précis et associé à des techniques de séquençage haut-débit peut conduire à l’identification de la cause génétique sous-jacente. En procédant ainsi, nous avons montré que des mutations récessives de FAM20A sont à l’origine du syndrome rein-dent (ERS). Les patients atteints présentent un phénotype oral pathognomonique caractérisé par une amélogénèse imparfaite, des retards d’éruption, des calcifications intra-pulpaires, des follicules dentaires surdéveloppés, une hyperplasie gingivale et une néphrocalcinose. Les mutations de FAM20A conduisent à une augmentation de chondroïtine sulfate et de la concentration de calcium extracellulaire ionisé, entraînant l’apparition de calcifications ectopiques. Notre travail montre qu’un phénotypage précis combiné à des méthodes d’investigations génétiques à haut-débit, contribue de manière significative à une meilleure compréhension des facteurs génétiques des fentes orales et/ou des anomalies dentaires. / Any genetic or environmental disturbances during craniofacial development and odontogenesis can lead to orofacial clefts (OFC) and/or dental anomalies. One of the most common cleft syndrome is the Van der Woude / popliteal pterygium syndrome (VWS/PPS) caused by IRF6 mutations. We screened IRF6 in sixteen VWS and two PPS families and analyzed the dental phenotype of IRF6-mutated patients. Affected individuals had clefts (76%), lower lip pits (86%), dental agenesis (68%), and abnormal dental morphology (58%) such as fused teeth and additional cusps, demonstrating that the high frequency of dental anomalies in VWS/PPS patients mutated for IRF6 could be a useful clinical clue for correct diagnosis, as lips pits are not always present. Despite the large number of genes identified in oral cleft and/or dental anomalies, the genetic causes of many sporadic cases remain unknown. Starting from syndromic cleft patients presenting chromosomal abnormalities, new genes associated with oral cleft were discovered: HDAC4, HIPK2, RBFOX1, SWSWAP, and MMP17. In addition to protein coding mutations and predisposing intronic variants, alterations of long-range gene regulatory elements can also lead to OFC, illustrated in this work with the alteration of SOX9 regulatory elements. Careful stratification of syndromic patients based on a precise phenotype can lead to the identification of the underlying genetic causes, when combined with high-throughput sequencing. We identified FAM20A recessive mutations to be causative of the Enamel Renal Syndrome (ERS). Affected patients present a pathognomonic oral phenotype characterized by generalized hypoplastic enamel, delayed tooth eruption, pulp calcifications, hyperplastic dental follicles, gingival hyperplasia, and nephrocalcinosis. FAM20A mutations resulted in increased chondroitin sulfate and increased extracellular ionized calcium concentrations, eventually leading to ectopic calcification. Our work illustrates that precise phenotype combined with the power of high throughput genetic technologies contributes significantly to the understanding of the genetic factors underlying oral cleft and/or dental anomalies.

Ce travail décrit la mise en oeuvre d’une démarche d’évaluation des pratiquesprofessionnelles mise en place dans le service d’odontologie du CHU de Clermont-Ferrandafin de définir la qualité et le résultat des traitements endodontiques. Un cycle de Deming, oucycle Plan-Do-Check-Act (PDCA) a été appliqué dans l’objectif de rechercher les facteursinfluençant la qualité et le résultat des traitements endodontiques, et de proposer lesaméliorations susceptibles d’assurer un meilleur service au patient. La phase Plan d’un cyclePDCA est la phase d’évaluation des pratiques. Elle se déroule en 6 étapes. Au cours de l’étape1, la pratique idéale pour la procédure a été évaluée, en référence aux recommandationsacadémiques. L’étape 2 a consisté au choix d’indicateurs permettant d’évaluer la proportionde traitements endodontiques adéquats et le résultat du traitement endodontique. Au cours del’étape 3, la qualité et le résultat des traitements endodontiques réalisés dans le serviced’odontologie de Clermont-Ferrand ont été évalués à l’aide des indicateurs définis à l’étape 2.Les facteurs influençant la qualité et le résultat ont également été recherchés. Au terme del’évaluation, deux actions d’amélioration ont été proposées. Il s’agit d’une part de la mise enplace d’un arbre décisionnel des procédures du traitement, prenant en compte le type de dent,l’état pulpaire, et la difficulté prévisible du ou des canaux et d’autre part de l’organisation durappel systématique des patients et de la gestion des traitements en échec. Au CHU deClermont-Ferrand, la procédure d’amélioration des pratiques se poursuit par la mise en placede ces actions dans le contexte de la phase « Do » du cycle PDCA. / Objectives: Plan-Do-Check-Act (PDCA) cycles are a methodology used to improveprofessional practices. This study presents the Plan phase that identifies and analyses clinical practicesin endodontics in a university dental hospital service.Methods: The plan phase was divided into six steps. Step 1 identified the quality and the outcome ofEndodontic Treatment (RCT) as the targeted procedure for PDCA referring to academic guidelines. InStep 2, an evidence based approach indicated the use of the proportions of RCTs with adequate qualityand the proportions of RCTs that were effective in the PDCA approach. Step 3 evaluated RCTs duringthree consecutive years. Step 4 compared the results from Step 3 with data from the literature. Step 5identified the factors acting on the quality and the outcome of RCTs. Step 6 proposed actions supposedto improve RCTs. Steps 1 to 5 were conducted by three PDCA managers, and the staff of teachers inendodontics was enrolled for consensual decisions in Step 6.Results: Step 3 reported that the proportion of RCTs with adequate quality reached 57.1% and thisproportion was significantly decreased when specific indicators for treatment difficulties were present.The proportion of successful RCTs after one year was 65.6% and its variation was influenced by thepreoperative periapical status, but not by the quality of RCTs. The consensual meeting in Step 6proposed five procedures to be implemented for the further Do phase of PDCA cycle.Conclusion: This study encourages systematic evaluation of RCTs in private and hospital practices.