Orientador: João Neudenir Arioli Filho / Resumo: O posicionamento e forma oclusal dos dentes posteriores, assim como a utilização de implantes dentários, podem contribuir com uma adequada função mastigatória de usuários de próteses totais. Neste contexto, os objetivos do estudo clínico randomizado cruzado foram: (1) avaliar a eficiência mastigatória (EM), força máxima de mordida (FM) de portadores de próteses totais duplas e portadores de prótese total no arco superior e overdenture retida por um implante no arco inferior, confeccionadas com oclusão balanceada bilateral e lingualizada e (2) avaliar a autopercepção da saúde bucal destes indivíduos. Vinte e seis pacientes receberam próteses totais duplas, com dentes intercambiáveis na prótese inferior, permitindo a troca dos padrões oclusais. Posteriormente, cada paciente recebeu um implante na região de sínfise mandibular e as próteses totais inferiores foram convertidas em overdentures implantorretidas. A EM foi realizada através da mastigação de cubos de silicone de condensação e mensurada pelo método das peneiras, enquanto que a FM foi mensurada pela utilização de um gnatodinamômetro. Para avaliação da autopercepção de saúde bucal foi utilizado o índice de determinação da saúde bucal geriátrica (GOHAI). Os resultados mostram que não houve diferença estatística para EM (p=0,813) e FM (p=0,074) em usuários de próteses totais convencionais quando comparados diferentes padrões oclusais. Para overdentures mandibulares, em relação aos padrões oclusais, também não foram obtidos ... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: The positioning and occlusal design of posterior teeth, as well as the use of dental implants, may contribute with an adequate masticatory function of removable complete denture wearers. In this context, the aims of this randomized crossover clinical trial were: (1) evaluate the masticatory efficiency (ME) and maximum bite force (BF) of wearers of maxillary and mandibular removable complete dentures and wearers of maxillary complete denture and single-implant mandibular overdenture, made with bilateral balanced occlusion and lingualized balanced occlusion, (2) evaluate the self-perception of these. Twenty six patients received maxillary and mandibular removable complete dentures, with interchangeable teeth in the mandibular prosthesis, allowing the exchange of occlusal patterns. Subsequently, each patient received an implant in the mandibular symphysis region and the mandibular complete dentures were converted into implant retained overdentures. ME was performed by the chewing of condensation silicone cubes and measured by sieve method, while the BF was measured with a gnathodynamometer. To evaluate the self-perception of oral health the General Oral Health Assessment Index (GOHAI) was used. The results show that there was no statistical difference for ME (p = 0.813) and BF (p=0.074) in wearers of removable complete dentures when different occlusal patterns were compared. For mandibular overdentures, in relation to occlusal patterns, no significant results were also obtained ... (Complete abstract click electronic access below) / Doutor

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Orientador: Joni Augusto Cirelli / Resumo: Tratamentos de superfície, desenvolvimento de novas ligas e funcionalização das superfícies dos implantes com elementos bioativos têm sido objetivos de estudos recentes na área da Odontologia visando contribuir para o processo de osseointegração. Nesse trabalho, dois estudos investigaram a influência na resposta celular in vitro e de propriedades físico-químicas de ligas de Ti-15Mo submetidas a (1) funcionalização com estrôncio pelo método hidrotérmico previamente submetidas ou não ao tratamento químico por ácido (H3PO4) e base (NaOH) e a (2) dois métodos de aplicação de estrôncio método hidrotermal e método magnetron co-sputtering. Testes de composição química e topografia demonstraram que ambas as técnicas foram efetivas na aplicação de estrôncio. Em (1) o método hidrotermal conciliado a tratamento prévio com ácido e base apresentou resultados de maior quantificação de estrôncio com liberação mais lenta além de melhores resultados nas análises de molhabilidade, energia de superfície e resistência a corrosão. Os ensaios biológicos verificaram que em (1) células pré-osteoblásticas MC3T3-E1 apresentaram características morfológicas de maior espraiamento e proliferação em superfícies com adição de estrôncio. Em (2) células humanas do ligamento periodontal os resultados demonstraram maior proliferação e espraiamento em superfícies tratadas pelo método magnetron co-sputtering. Os estudos demonstraram que a adição de estrôncio contribuiu para os eventos celulares e, conciliadas co... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Surface treatments, development of new alloys and functionalization of implant surfaces with bioactive elements have been the objectives of recent studies in the field of Dentistry aimed at contributing to the process of osseointegration. In this dissertation, two studies investigated the influence on the in vitro cellular response and physical-chemical properties of Ti-15Mo alloys submitted to (1) strontium functionalization by the hydrothermal method previously submitted or not to chemical treatment with acid (H3PO4) and alkali (NaOH) and (2) two methods of strontium application: hydrothermal method and magnetron co-sputtering method. Tests of chemical composition and topography demonstrated that both techniques were effective in the application of strontium. In (1) the hydrothermal method reconciled the previous treatment with acid and alkali presented results of greater strontium quantification with slower release and better results in the analysis of wettability, surface energy and corrosion resistance. The biological tests verified that in (1) preosteoblastic cells MC3T3-E1 presented morphological characteristics of greater spreading and proliferation on surfaces with strontium addition. In (2) human periodontal ligament cells the results showed greater proliferation and spreading on surfaces treated by the magnetron co-sputtering method. The studies demonstrated that the addition of strontium contributed to cellular events and, combined with chemical treatment prior to... (Complete abstract click electronic access below) / Mestre

Orientador: Idelmo Rangel Garcia Júnior / Banca: Celso Koogi Sonoda / Banca: Thallita Pereira Queiroz / Resumo: O propósito deste trabalho foi avaliar o efeito da osteotomia para implantes, seguindo o protocolo de cirurgia guiada comparando-o com a clássica, sobre o aquecimento tecidual, bem como verificar o desgaste das fresas por microscopia eletrônica de varredura e a viabilidade celular imediata. Para isso foram utilizadas tíbias de 20 coelhos, divididos em 2 grupos - GRUPO CONTROLE (GC) e GRUPO GUIADA (GG) - os quais foram divididos em 5 subgrupos (G): G0, GI, G2, G3, G4, que corresponderam às fresas sem uso e as utilizadas 10, 20, 30 e 40 vezes, respectivamente. Cada animal recebeu 10 seqüências de osteotomias, sendo 5 de cada grupo, aleatoriamente em cada tíbia, na velocidade de 1600 r.p.m, e por meio de irrigação externa. A oscilação térmica tecidual durante cada fresagem foi quantificada por meio de termopares. As brocas foram analisadas por microscopia eletrônica de varredura (MEV) e a quantificação da deformação das fresas foi realizada por meio do software ImageLab 2000. As áreas osteotomizadas foram coletadas, processadas para inclusão em parafina, e submetidas ao processamento imunoistoquímico para a expressão das proteínas osteoprotegerina (OPG), Receptor Ativador do Fator Nuclear k (RANKL), osteocalcina (OC) e caspase 3(cas 3). Os dados obtidos por meio da análise térmica foram submetidos ao teste de Mann-Whitney (p=0,05), já os valores de deformação das brocas foram submetidos ao teste t. O aquecimento ósseo no GG foi estatisticamente maior do que no GC. Na análise por meio do MEV, não houve diferença estatística entre os grupos, mas verificou-se que a deformação foi progressiva de acordo com a maior utilização das fresas. Na análise da viabilidade celular, não houve diferença... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: The purpose of this study was to evaluate the effect of osteotomy for implants, following the protocol guided surgery comparing it with the classical, tissue heating, check the wear of the drills by scanning electron microscopy, and cell viability. For such purpose, the tibia of 20 rabbits were divided into 2 groups - Control Group (CG) and GUIDED GROUP (GG) - which were divided into five subgroups (G): G0, GI, G2, G3, G4, which corresponded to the cutters without used and used 10, 20, 30 and 40 times respectively. Each animal received 10 sequences osteotomies, 5 in each group randomly in each tibia at a speed of 1600 rpm, and through external irrigation. The tissue thermal oscillation during each milling was measured using thermocouples. The drills were analyzed by scanning electron microscopy (SEM), and quantification of the deformation of the cutters was performed using the software ImageLab2000. Osteotomized areas were collected, processed for paraffin, and subjected to immunohistochemical processing for the protein expression of osteoprotegerin (OPG), Receptor Activator of Nuclear Factor k (RANKL), osteocalcin (OC) and caspase 3 (cas 3). The data obtained by thermal analysis were tested using the Mann-Whitney test (p = 0.05), the strain values of the drills were tested using parametric t-test. Results in the heating bone in the GG was statistically higher than in CG. In the analysis by means of SEM, it was found that deformation was progressive in accordance with the increased use of milling drills. In the analysis of cell viability, no statistical difference when comparing each protein, OPG, RANKL and CASPASE-3, between groups. In the comparison between the OC and GG GC, there was a statistically significant difference. According to the... (Complete abstract click electronic access below) / Mestre

Orientador: Joni Augusto Cirelli / Resumo: A qualidade do tecido ósseo representa condição “sine qua non” para a estabilidade e longevidade de implantes biomédicos. Diante de fatores sistêmicos relacionados à insuficiência e/ou má qualidade do tecido ósseo peri-implantar, o desenvolvimento de superfícies de titânio com atividade osteogênica é amplamente incentivado na área da implantodontia. Sendo assim, este Estudo avaliou diferentes formas de tratamentos da superfície das amostras de titânio comercialmente puro (Ticp) e titânio liga 6Alumínio-4Vanádio, que visam o favorecimento dos mecanismos celulares de osteogênese. Este estudo foi divido em 2 capítulos. Na publicação 1 as amostras foram divididas em 3 grupos de acordo com os tratamentos (Grupo 1: Titânio comercialmente puro – MS; Grupo 2: Tratamento com NaOH - AES; Grupo 3: Tratamento com NaOH associado à deposição de Estrôncio (Sr) – Sr-AES. Os resultados demonstraram que as superfícies dos Grupos 2 e 3 apresentaram-se mais rugosas, quando avaliadas em perfilômetro, e mais hidrofílicas em teste de molhabilidade, em comparação às do Grupo 1 (p < 0.05, One Way Anova). As células em contato com a superfície do Grupo 3 apresentaram espraiamento celular mais evidente, em comparação aos Grupos 1 e 2, indicando que a adição do estrôncio às amostras foi favorável ao desenvolvimento das células precursoras ósseas. Na publicação, as amostras foram divididas em 3 grupos de acordo com os diferentes tratamentos. Grupo A: titânio comercialmente puro – Ticp; Grupo B: Ti-6Al-4V... (Resumo completo, clicar acesso eletrônico abaixo) / Doutor

Magister Chirurgiae Dentium (MChD) / Background: Lack of appropriate bone thickness is a common clinical limitation for tooth replacement, often requiring narrow implants, which have shown better results when combined with Morse taper connections. Little is known about the sealing of the abutment-implant interface of narrow implants with Morse taper connections against oral bacteria. Aims: To investigate the in vitro ability of four commercially available narrow diameter implant (< 3.5 mm) with Morse-taper type implant abutment connections to impede bacterial penetration of their implant abutment interface (IAI). Material and Methods: Four commercially available narrow implant systems with Morse taper connections were subjected to Streptococcus sanguinis cultures in vitro and evaluated for contamination and microgaps through Scanning Electron Microscopy (SEM). Results: Bacterial penetration of the IAI was observed in all systems (n=12), ranging from 65 to >300 CFU. There were no statistically significant differences in the average log CFU between the four implant groups (χ2= 5.244, P=0.155). Microgaps ranging from 5-10 μm were observed in all assemblies when analyzed under SEM, with no statistically significant differences between the different systems (P>0.05). Conclusions: Despite the advantages of Morse taper systems, the evaluated narrow diameter implants using this type of abutment geometry failed to provide bacterial sealing. The observed microgaps can form reservoirs and potentially lead to inflammation in the peri-implant tissues and micromovements.

BACKGROUND: Static and dynamic dental implant guidance systems have established themselves as effective choices that result in predictable and relatively accurate dental implant placement. Generally, studies assess this accuracy using a postoperative CBCT, which has disadvantages such as additional radiation exposure for the patient. This pilot study proposed a scanbody-agnostic method of implant position assessment using intraoral scanning technology and applied it as an accuracy test of robotically assisted dental implant placement using the Neocis Yomi. MATERIALS AND METHODS: All of the robotically assisted dental implant surgery was performed in the Postdoctoral Periodontology clinic at Boston University Henry M. Goldman School of Dental Medicine. Completely edentulous patients were excluded. A total of eleven (11) implants were included in the study, eight (8) of which were fully guided. An optical impression of each implant position was obtained using a CEREC Omnicam (SW 5.1) intraoral scanner. Each sample used either a DESS Lab Scan Body or an Elos Accurate Scan Body as a means to indirectly index the position of the implant. A comparison of planned implant position versus executed surgical implant position was performed for each placement using Geomagic Control X software. Global positional and angular deviations were quantified using a proposed scanbody-agnostic method. Intraoral directionality of deviation was visually qualified by the author (D.K). RESULTS: Mean global positional deviations at the midpoints of the top of each scanbody were 1.7417 mm in the partially guided samples and 1.1300 mm in the fully guided samples. Mean global positional deviations at the midpoints of the restorative platforms of each implant were 1.3142 mm in the partially guided sample and 1.27045 mm in the fully guided samples. Mean global positional deviations at the midpoints of the apex of each implant were 1.455 mm in the partially guided samples and 1.574 mm in the fully guided samples. Mean angular deviations were 3.7492 degrees in the partially guided samples and 2.6432 degrees in the fully guided samples. CONCLUSION: Within the sample size limitations, robotically assisted dental implant surgery offers similar implant placement accuracy compared to published static and dynamic implant placement guidance systems. Intraoral optical assessment of dental implant position used in this study allows comparable analysis to other methods without requiring additional exposure to radiation and should be considered the default method of assessing guidance accuracy.

Indiana University-Purdue University Indianapolis (IUPUI) / Anchorage control is fundamental to successful orthodontic treatment. Dental implants can serve as ideal anchorage units because of their stability in bone. Previous studies limit the use of existing implants for anchorage because of their large size. Minimizing the size of the implant would reduce the extent of the surgery and may result in a decreased and less traumatic healing period. The objective of this study was to histomorphometrically analyze the use of miniature implants. A total of 96 miniature implants (1.0 x 5.0 mm; 48 loaded and 48 healing control) were placed in the mandible and maxilla of 8 male dogs. The implants were allowed to heal for three different periods (3, 6, and 12 weeks) followed by 12 weeks of 200 to 300 g of orthodontic force application. Bone specimens containing implants were collected for histomorphometric analysis. The results indicate that clinical rigidity (osseointegration) was achieved by 96.9 percent of the miniature implants. Histomorphometric analysis revealed that the amount of bone contact at the implant-bone interface ranged from 11.3 to 68 percent (mean ± SEM=34.4 ± 4.6 percent) in the healing control groups and from 18.8 to 63 percent (mean=43.l ± 4.0 percent) in the force applied groups in the maxilla. On the other hand, in the mandible, bone-implant contact ranged from 7 to 82 percent (mean=44.1 ± 6.8 percent) in the healing control groups and from 12 to 72 percent (mean=50.7 ± 5.3 percent) in the force applied groups. Results from bone formation rate, mineralizing surface/bone surface and mineral appositional rate showed a significant difference in the 3-week healing control group compared to those in other groups. From these results, we concluded that miniature implants are able to function as rigid osseous anchorage for orthodontics with minimal (less than 3 weeks) healing period. This study was supported by Matsumoto Research fund.

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