Whole-body vibration (WBV) was recently introduced as a potential modality for strengthening bones, and this thesis was set out to investigate whether it plays a role in the prevention of postmenopausal bone loss. First, effects of WBV on bone mineral density (BMD) were systematically evaluated in previous randomized controlled trials (RCTs) in postmenopausal women. Second, a RCT of 202 postmenopausal women with primary osteopenia not on bone medications was conducted to investigate the effects of WBV at 0.3g and 90 Hz versus 0.3g and 30 Hz versus controls on various bone outcomes, as measured by dual-energy x-ray absorptiometry (DXA), high-resolution peripheral quantitative computed tomography (HR-pQCT), and quantitative ultrasound (QUS). In the systematic evaluation of previous RCTs, statistically significant increase in areal BMD (aBMD) at the hip was found in postmenopausal women receiving WBV versus controls, but the effect was small and may have been due to study bias. Also, WBV was not found to influence aBMD at the lumbar spine or volumetric BMD (vBMD) at the distal tibia in the systematic evaluation. In the RCT conducted in this thesis, no statistically significant effects of WBV were found on aBMD at the femoral neck, total hip or lumbar spine, as measured by DXA, or on vBMD or bone structure parameters at the distal tibia or distal radius, as measured by HR-pQCT. Further in this RCT, a statistically significant decrease was observed in QUS attenuation at the calcaneus in women receiving 90 Hz or 30 Hz WBV compared to controls. This may have been due to heel bone or soft tissue damage, although the effect was small and may not be clinically important. In conclusion, this investigation of postmenopausal women did not find clinically relevant benefits of WBV on osteoporotic-prone skeletal sites, including the hip, spine, tibia or radius, while potentially harmful effects on heel bone and/or soft tissue was observed in response to WBV. Thus based on this thesis, WBV is currently not recommended for the prevention of bone loss in community-dwelling postmenopausal women with primary osteopenia.

This project examined the effect of splinting adjacent dental implants of different designs [Sintered porous surface (SPS), Threaded dual acid etched (THR-DAE), Threaded sand-blasted large grit acid etched (THR-SLA)] placed in posterior sites and compared two intraoral radiographic techniques to assess peri-implant crestal bone levels. 799 implants located in 345 patients qualified and were examined retrospectively using an inclusion criteria of a minimum one year in function and having a recent periapical (PA) and vertical bitewing radiograph (vBW). SPS had less bone loss than THR-DAA and THR-SLA. PA views showed approximately 0.10 mm (Range 0.07-0.40 mm) less crestal bone loss than vBW (P<0.01). Splinted implants had more crestal bone loss (0.30 mm; range 0.16-0.38 mm) than non-splinted implants. 49 implants failed with an overall failure rate of 4.9% with a significant difference in the failure rate of SPS and THR-DAA (P<0.0005) and in the time to fail (P<0.0036).

This project examined the effect of splinting adjacent dental implants of different designs [Sintered porous surface (SPS), Threaded dual acid etched (THR-DAE), Threaded sand-blasted large grit acid etched (THR-SLA)] placed in posterior sites and compared two intraoral radiographic techniques to assess peri-implant crestal bone levels. 799 implants located in 345 patients qualified and were examined retrospectively using an inclusion criteria of a minimum one year in function and having a recent periapical (PA) and vertical bitewing radiograph (vBW). SPS had less bone loss than THR-DAA and THR-SLA. PA views showed approximately 0.10 mm (Range 0.07-0.40 mm) less crestal bone loss than vBW (P<0.01). Splinted implants had more crestal bone loss (0.30 mm; range 0.16-0.38 mm) than non-splinted implants. 49 implants failed with an overall failure rate of 4.9% with a significant difference in the failure rate of SPS and THR-DAA (P<0.0005) and in the time to fail (P<0.0036).

Whole-body vibration (WBV) was recently introduced as a potential modality for strengthening bones, and this thesis was set out to investigate whether it plays a role in the prevention of postmenopausal bone loss. First, effects of WBV on bone mineral density (BMD) were systematically evaluated in previous randomized controlled trials (RCTs) in postmenopausal women. Second, a RCT of 202 postmenopausal women with primary osteopenia not on bone medications was conducted to investigate the effects of WBV at 0.3g and 90 Hz versus 0.3g and 30 Hz versus controls on various bone outcomes, as measured by dual-energy x-ray absorptiometry (DXA), high-resolution peripheral quantitative computed tomography (HR-pQCT), and quantitative ultrasound (QUS). In the systematic evaluation of previous RCTs, statistically significant increase in areal BMD (aBMD) at the hip was found in postmenopausal women receiving WBV versus controls, but the effect was small and may have been due to study bias. Also, WBV was not found to influence aBMD at the lumbar spine or volumetric BMD (vBMD) at the distal tibia in the systematic evaluation. In the RCT conducted in this thesis, no statistically significant effects of WBV were found on aBMD at the femoral neck, total hip or lumbar spine, as measured by DXA, or on vBMD or bone structure parameters at the distal tibia or distal radius, as measured by HR-pQCT. Further in this RCT, a statistically significant decrease was observed in QUS attenuation at the calcaneus in women receiving 90 Hz or 30 Hz WBV compared to controls. This may have been due to heel bone or soft tissue damage, although the effect was small and may not be clinically important. In conclusion, this investigation of postmenopausal women did not find clinically relevant benefits of WBV on osteoporotic-prone skeletal sites, including the hip, spine, tibia or radius, while potentially harmful effects on heel bone and/or soft tissue was observed in response to WBV. Thus based on this thesis, WBV is currently not recommended for the prevention of bone loss in community-dwelling postmenopausal women with primary osteopenia.

Diss. (sammanfattning) Stockholm : Karol. inst., 2005. / Härtill 4 uppsatser.

Thesis (Doctoral)--Umeå University, Sweden, 1995. / Added t.p. with thesis statement inserted. Includes bibliographical references.

Thesis (Doctoral)--Umeå University, Sweden, 1995. / Added t.p. with thesis statement inserted. Includes bibliographical references.

Thesis (M.S.)--University of Florida, 2005. / Typescript. Title from title page of source document. Document formatted into pages; contains 45 pages. Includes Vita. Includes bibliographical references.

Orientador: Elcio Marcantonio Junior / Banca: Raphael Carlos Comelli Lia / Banca: Marcio Fernando de Moraes Grisi / Banca: Valdir Gouveia Garcia / Banca: Patricia Helena Rodrigues de Souza / Resumo: Este trabalho tem como objetivo avaliar a eficácia do uso de enxerto de tecido conjuntivo comparativamente a regeneração tecidual guiada, no tratamento de defeitos infra-ósseos. Para tanto, foram realizados dois estudos. No Estudo 1, defeitos infra-ósseos bilaterais foram criados na mesial dos caninos superiores de cinco cães, que após o período de cronificação (seis semanas), foram raspados e alisados. Duas semanas depois, as lesões foram aleatoriamente tratadas com enxerto de tecido conjuntivo (grupo ETC) ou membrana reabsorvível (grupo RTG). Dados clínicos foram colhidos previamente à cirurgia e 12 semanas após. Neste último período, os animais foram mortos, e procedeu-se à confecção das lâminas histológicas. Na análise dos resultados não foram detectadas diferenças estatisticamente significantes entre os grupos, porém, em ambos os grupos contatou-se redução da profundidade de sondagem (p=0,032). A análise histológica revelou menor extensão de novo cemento (p=0,001), de novo osso (p=0,003), e da extensão total de tecido conjuntivo (p=0,013) no grupo ETC em comparação com o RTG. Para o Estudo 2 foram selecionados 12 pacientes com defeitos infra-ósseos bilaterais, de duas ou três paredes, que após tratamento básico periodontal foram indicados para terapia cirúrgica no modelo de boca-dividida. Aleatoriamente, os defeitos periodontais foram designados a fazer parte do grupo ETC ou RTG. Avaliações clínicas e tomadas radiográficas foram realizadas previamente à cirurgia, seis e 12 meses pós-operatórios. Diferenças estatisticamente significantes não foram detectadas entre os grupos, porém, em ambos observou-se redução da PS (p=0,000), e aumento de recessão (p=0,002). Apenas o grupo RTG apresentou ganho de inserção (p=0,004). / Abstract: This research aims to evaluate the effectiveness of the use of connective tissue graft comparatively to the guided tissue regeneration, in the treatment of infrabony defects. Hence, two studies were developed. In Study 1, bilateral infrabony defects were created in the mesial aspect of the superior canines of five dogs. After six weeks of chronification, the defects were scaled and planned. Two weeks after, the lesions were randomly treated with connective tissue graft (CTG group) or with reabsorbable membrane (GTR group). Clinical data were recorded previously and 12 weeks after surgery. In this last period, the animals were killed, and histological slides were prepared. Clinical analysis did not reveal statistically significant differences between groups, however, both groups presented reduction of the probing depth (PD) (p=0.032). Histological analysis revealed lower extension of new cement (p=0.001), new bone (p=0.003), and total connective tissue (p=0.013) in CTG group when compared to GTR groups. In Study 2, 12 patients were selected with bilateral infrabony defects, with two or three walls, which after basic periodontal treatment were referred to surgical therapy as a split-mouth design. Randomly, the defects were designed to be part of the CTG or GTR group. Clinical analysis and radiographies were performed previously, six and 12 weeks post-surgery. Statistically significant differences were not detected between groups, but both groups presented reduction of PD (p=0.000), and increase of recession (p=0.002). Gain of attachment occurred only in GTR group (p=0.004). Within the limits of the present study, it can be concluded that connective tissue graft was not efficient in the treatment of infrabony lesions with two and three walls. / Doutor

Made available in DSpace on 2014-06-11T19:33:24Z (GMT). No. of bitstreams: 0 Previous issue date: 2011-07-05Bitstream added on 2014-06-13T20:44:51Z : No. of bitstreams: 1 perrella_fa_dr_sjc.pdf: 2692484 bytes, checksum: 5297a6084221ad4ddcef147cf5f213aa (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / O objetivo desse estudo foi avaliar o efeito do uso local de uma solução aquosa de risendronato de sódio (RS) em diferentes concentrações na inibição da perda óssea alveolar decorrente de periodontite experimental induzida em ratas. Os 48 animais foram divididos em 2 grupos constituídos por 24 animais: GD (dupla aplicação) e GU (única aplicação). Os dois grupos foram subdivididos em 8 subgrupos: R1 (duas aplicações de 0,125 mg de RS), R2 (duas aplicações de 0,25 mg de RS), R3 (duas aplicações de 0,5 mg de RS) e A1 (duas aplicações de água destilada); R4 (uma aplicação de 0,125 mg de RS), R5 (uma aplicação de 0,25 mg de RS), R6 (uma aplicação de 0,5 mg de RS) e A2 (uma aplicação de água destilada). Foi induzida a periodontite pela confecção de ligaduras ao redor dos primeiros molares inferiores direitos em todos os animais. Nos grupos A1 e A2, os molares contralaterais serviram de controles negativos (C1 e C2). A medicação foi aplicada aos 5 e 10 dias após indução da periodontite nos animais do GD, e nos animais do GU apenas aos 10 dias. Decorrente 15 dias os animais foram submetidos à eutanásia. Foram feitas análises histológica, histomorfométrica, imuno-histoquímica anti-osteocalcina e enzimo-histoquímica para TRAP (fosfatase ácida tartarato resistente). Os grupos que receberam RS exibiram maior volume trabecular da crista óssea remanescente que o controle significante estatísticamente, mas não foram observados diferenças entre os grupos tratados. A perda óssea alveolar foi menor nos grupos tratados com risendronato comparado com controle e foi dose-dependente. Os grupos que receberam a menor dose (R1 e R4) apresentaram menor perda óssea estatisticamente... / The aim of this study was to evaluate the local use of an aqueous solution of sodium risendronate (RS) at different concentrations on the inhibition of alveolar bone loss caused by experimental periodontitis induced in rats. The 48 animals were divided into two groups consisting of 24 animals: GD (double application) and GU (one application). The two groups were subdivided into eight subgroups: A1 (two applications of 0.125 mg RS), R2 (two applications of 0.25 mg RS), R3 (two applications of 0.5 mg RS) and A1 (two applications of distilled water), and R4 (one application of 0.125 mg RS), R5 (one application of 0.25 mg RS), R6 (one application of 0.5 mg RS) and A2 (one applications with distilled water). Periodontitis was induced in first molars in all animals. In groups A1 and A2, the contralateral molars served as controls (C1 and C2). The medication was applied at 5 and 10 days after induction of periodontitis in animals of GD, and animals of GU only after 10 days. After 15 days the animals were euthanized. Analysis was performed on histological, histomorphometric, immunohistochemical antiosteocalcin and enzimohistochemical for TRAP (tartrate resistant acid phosphatase). The groups that received RS exhibited greater volume of trabecular bone crest that controlling statistically significant, but no differences were observed between treated groups. The alveolar bone loss was lower in treated groups compared with placebo and was dose-dependent. The groups that received the lowest dose (R1 and R4) showed statistically significant less bone loss than the intermediate dose (R2 and R5), which in turn exhibited lower rates compared with higher doses (R3 and R6). The two types of approaches, however, did not show statistical significance. The number of TRAP-positive cells was... (Complete abstract click electronic access below)