<p>U uvodnom delu doktorske disertacije opisane su osnovne konvencionalne metode otiskivanja, kao i modifikovane tehnike koje se koriste u savremenoj implant protetici. Prikazana je specifičnost biomehanike implantno no&scaron;enih i poduprtih nadoknada u odnosu na biomehaniku nadoknada retiniranih prirodnim zubima. Akcenat je stavljen na kompleksnost problematike postizanja apsolutno pasivnog naleganja nadoknade na nosač implanta (abatment), sa posebnim osvrtom na uticaj same procedure otiskivanja implanata i angulacije implanata na tačnost naleganja. Detaljno su opisani i svi ostali faktori koji mogu da utiču na tačnost radnih modela pri izradi nadoknada na implantima, pozivajući se na aktuelne podatke iz literature i naučno opravdanje za potrebe istraživanja. Cilj rada je bio ispitati uticaj metode otiskivanja, angulacije implanata i vrste otisnog materijala na tačnost definitivnog radnog modela za izradu implantno no&scaron;enih zubnih nadoknada. Eksperiment je obavljen u in vitro uslovima. Istraživanje je bazirano na ispitivanju tačnosti otiskivanja pomoću tri različite metode otiskivanja (direktne, indirektne i modifikovane &bdquo;splint&ldquo; metode), dve vrste elastičnih otisnih materijala (adicionog silikona i polietra) i uticaja dve različite grupe implanata (anguliranih od 20&deg; i paralelnih implanata) na tačnost otiskivanja. Master (referentni) model je isplaniran tako da simulira čest klinički slučaj parcijalne bezubosti gornje vilice (klasa Kenedi I), koji je osim dva ugrađena angulirana implanta sa jedne, i dva paralelna implanta sa druge strane, podrazumevao i prisustvo bru&scaron;enih zuba, pripremljenih za prihvatanje keramičkog mosta u frontalnoj regiji. Otiskivanje zuba i implanata vr&scaron;eno je istovremeno i drugi deo istraživanja je obuhvatao ispitivanje uticaja primenjene metode i materijala na tačnost otisnutih povr&scaron;ina zuba. Time je pro&scaron;ireno polje istraživanja i omogućeno dono&scaron;enje zaključka o pravoj indikaciji metode i materijala za otiskivanje konkretnog kliničkog slučaja. Kompletna metodologija izrade master i definitivnih radnih (replika) modela, kao i sama procedura otiskivanja, izvedena je po najsavremenijim principima istraživanja, uz upotrebu instrumenata i materijala vodećih svetskih proizvođača. Za potrebe analize odstupanja implanata i zuba na replica modelima u odnosu na referentni, modeli su podvrgnuti optičkoj 3D (trodimenzionalnoj) digitalizaciji pomoću dva savremena laboratorijska skenera koje karakteri&scaron;e izuzetna tačnost skeniranih povr&scaron;ina. Prvo je digitalizovan master model za potrebe dobijanja nominalne geometrije, a nakon toga 30 replika modela, za potrebe uporedne geometrijske analize. Analiza je vr&scaron;ena pomoću najnovijeg specijalizovanog softverskog programa, primenom metode CAD-inspekcije (eng. Computer-Aided Design). Geometrijska analiza odstupanja bru&scaron;enih zuba (patrljaka) izvedena je tehnikom preklapanja odnosno superpozicije (eng. bestfit) realne geometrije (na replika modelu) sa nominalnom geometrijom (na master modelu). Za razliku od analize patrljaka, za potrebe geometrijske analize odstupanja implanata kreiran je lokalni koordinatni sistem za svaki analizirani implant, pomoću specijalnih abatmenta upotrebljenih za digitalizaciju i uvozom 3D modela implanata iz CAD biblioteke proizvođača. Odstupanja su analizirana u odnosu na centar baze implanta (odstupanje od centra) i u odnosu na centralnu osu implanta (ugao odstupanja), &scaron;to je omogućilo tačno prostorno orijentisanje implanata na replika modelima u poređenju sa referentnim. Ova metodologija je originalna, jer je u odnosu na metodologije koje su do sada kori&scaron;ćene u svrhu prostorne orijentacije implanata, uvođenjem novih parametara u analizu, omogućila tačnije defi nisanje prostornog odstupanja analiziranih implanata. Rezultati dobijeni u istraživanju doveli su do zaključka da metoda otiskivanja i vrsta otisnog materijala utiču na tačnost otiskivanja implanata. Takođe, angulacija implanata od 20&deg; ima veći uticaj na tačnost definitivnih radnih modela u poređenju sa paralelnim angulirana implanta sa jedne, i dva paralelna implanta sa druge strane, podrazumevao i prisustvo bru&scaron;enih zuba, pripremljenih za prihvatanje keramičkog mosta u frontalnoj regiji. Otiskivanje zuba i implanata vr&scaron;eno je istovremeno i drugi deo istraživanja je obuhvatao ispitivanje uticaja primenjene metode i materijala na tačnost otisnutih povr&scaron;ina zuba. Time je pro&scaron;ireno polje istraživanja i omogućeno dono&scaron;enje zaključka o pravoj indikaciji metode i materijala za otiskivanje konkretnog kliničkog slučaja. Kompletna metodologija izrade master i definitivnih radnih (replika) modela, kao i sama procedura otiskivanja, izvedena je po najsavremenijim principima istraživanja, uz upotrebu instrumenata i materijala vodećih svetskih proizvođača. Za potrebe analize odstupanja implanata i zuba na replika modelima u odnosu na referentni, modeli su podvrgnuti optičkoj 3D (trodimenzionalnoj) digitalizaciji pomoću dva savremena laboratorijska skenera koje karakteri&scaron;e izuzetna tačnost skeniranih povr&scaron;ina. Prvo je digitalizovan master model za potrebe dobijanja nominalne geometrije, a nakon toga 30 replika modela, za potrebe uporedne geometrijske analize. Analiza je vr&scaron;ena pomoću najnovijeg specijalizovanog softverskog programa, primenom metode CAD-inspekcije (eng. Computer-Aided Design). Geometrijska analiza odstupanja bru&scaron;enih zuba (patrljaka) izvedena je tehnikom preklapanja odnosno superpozicije (eng. bestfit) realne geometrije (na replika modelu) sa nominalnom geometrijom (na master modelu). Za razliku od analize patrljaka, za potrebe geometrijske analize odstupanja implanata kreiran je lokalni koordinatni sistem za svaki analizirani implant, pomoću specijalnih abatmenta upotrebljenih za digitalizaciju i uvozom 3D modela implanata iz CAD biblioteke proizvođača. Odstupanja su analizirana u odnosu na centar baze implanta (odstupanje od centra) i u odnosu na centralnu osu implanta (ugao odstupanja), &scaron;to je omogućilo tačno prostorno orijentisanje implanata na replika modelima u poređenju sa referentnim. Ova metodologija je originalna, jer je u odnosu na metodologije koje su do sada kori&scaron;ćene u svrhu prostorne orijentacije implanata, uvođenjem novih parametara u analizu, omogućila tačnije definisanje prostornog odstupanja analiziranih implanata. Rezultati dobijeni u istraživanju doveli su do zaključka da metoda otiskivanja i vrsta otisnog materijala utiču na tačnost otiskivanja implanata. Takođe, angulacija implanata od 20&deg; ima veći uticaj na tačnost definitivnih radnih modela u poređenju sa paralelnim implantima. Time su potvrđene radne hipoteze doktorske disertacije. &bdquo;Splint&ldquo; metoda otiskivanja i adicioni silikon izdvojili su se kao najtačniji pri otiskivanju implanata. Kombinacije &bdquo;splint&ldquo; metode sa adicionim silikonom i polietrom i otvorene metode sa adicionim silikonom dale su bolje rezultate pri otiskivanju anguliranih implanta, dok je u grupi paralelnih implanata zaključeno da metoda i materijal ne utiču na tačnost otiskivanja. &bdquo;Splint&ldquo; i otvorena metoda i adicioni silicon pružili su najtačnije otiske bru&scaron;enih zuba. &bdquo;Splint&ldquo; metoda u kombinaciji sa adicionim silikonom dala je najmanja ukupna odstupanja pri otiskivanju implanata i zuba zajedno. Prezentovana studija je specifi čna, kako po izboru zadatog kliničkog slučaja I uporednoj analizi tačnosti istovremenog otiskivanja implanata i zuba, tako i po samoj metodologiji analiza odstupanja implanata, te predstavlja originalni doprinos naučnoj i stručnoj javnosti.</p> / <p>The introductory part of the PhD-theses describes fundamental conventional impression methods, as well as modified techniques used in modern-day implant prosthetics. The biomechanics specificity of the implant supported prosthesis in relation to the biomechanics of natural-teeth retained prosthetics is showed. The emphasis is on the issue&rsquo;s complexity at accomplishing the absolute passive fit of the prosthesis onto the abutment, with particular regard to the impact of the implant impression procedure and implant angulation its elf. A detailed description is provided for all other factors which can influence the accuracy of working casts during implant-based dental prosthesis, making reference to the current data in the literature, as well as to the scientific justification for research. The aim of the study was to examine the influence of the impression method, implant angulation and type of the impression material on the accuracy of the definitive working model for production of the implant-supported dental prosthesis. The experiment was conducted in the in vitro conditions. The research is based on examining the impression accuracy by using three different impression methods (direct, indirect, as well as modifi ed &ldquo;splint&rdquo; method), by using two types of elastic impression materials (addition silicone and polyether), as well as the impact from two different implant groups (angled at 20&deg;, and parallel ones). Master (referential) model was planned to simulate a common clinical case of the upper jaw partial edentulism (Kennedy 1st class), which apart from the two angulated implants on one side, and two parallel implants on the other, also presupposed presence of milled teeth, prepared to accept ceramic dental bridge in the frontal region. Impression of teeth and implants was conducted simultaneously, and second part of the research encompassed examination of the applied method&rsquo;s and material&rsquo;s impact onto accuracy of the impressed teeth surfaces. This expanded the research fi eld and enabled drawing conclusions regarding the appropriate method indication and material for impression of a particular clinical case. Complete production methodology of master and definitive working casts (replicas), as well as the impression procedure itself, were all conducted according to the cutting-edge research principles, as well as with the application of instruments and materials of leading world producers. For the purpose of the analysis of implants and teeth deviation on replica models in relation to the reference model, the models underwent optical 3D (three-dimenzional) digitalization by using two state-of-the-art laboratory scanners characterized by exceptional accuracy of scanned surfaces. First model to be digitalized was the master one, in order to obtain nominal geometry, following which 30 model replicas were scanned, for the purpose of comparative geometrical analysis. The analysis was conducted by using latest specialized software designed for CAD (Computer-Aided Design) inspection method. Geometric analysis of the milled teeth (tooth abutments) deviation was conducted by using the overlapping superposition technique (bestfit) real geometry (on the replica model) with nominal geometry (on the master model). As opposed to the teeth-stump analysis, for the purpose of geometrical analysis of implant deviations, a local coordinate system for each analyzed implant was created, by using special abutments used for digitalization and by importing 3D implant models from the manufacturer&rsquo;s CAD library. Deviations were analyzed in relation to the implant base center (deviation from the center), and in relation to the implant central axis (deviation angle), which enabled accurate implant spatial orientation on the replica models in comparison the referential ones. This methodology is original, since unlike methodologies used so far for implant spatial orientation, it has enabled, through introducing new parameters into analysis, a more accurate defining of analyzed implants spatial deviation. Results obtained during research have led to the conclusion that that the impression methodology and type of the impression material influence the implant impression accuracy. Also, implant angulation of 20&deg; has a higher impact on accuracy of definitive working models in comparison with parallel implants. This confirms the PhD-thesis working hypotheses. The &ldquo;splint&rdquo; impression method and addition silicone have excelled as most accurate at implant impression. Combination of &ldquo;splint&rdquo; methods with addition silicone and polyether and opened methods with addition silicone proved to obtain better results when impressing angulated implants, while in the group of parallel implants, it was concluded that the method and material do not infl uence the impression accuracy. The &ldquo;splint&rdquo; and the open method and addition silicone provided most accu rate imprints of ground teeth. The &ldquo;splint&rdquo; method in com bination with addition silicone provided the least over all deviation at impression of implants and teeth together. The presented study is a specifi c one, both in terms of selection of the given clinical case and comparative analysis of the simultaneous impression of teeth and implants, but also in terms of the methodology itself used to analyze implant deviation, which in its own right represents an original contribution to the scientific and expert public.</p>

Submitted by ANA FLÁVIA NUNES E REIS null (dra-anaflavia@uol.com.br) on 2016-01-26T19:16:31Z No. of bitstreams: 1 merged (4).pdf: 4937949 bytes, checksum: c052666784bd930ac4748e41040c73bd (MD5) / Approved for entry into archive by Ana Paula Grisoto (grisotoana@reitoria.unesp.br) on 2016-01-28T13:31:20Z (GMT) No. of bitstreams: 1 reis_afn_me_sjc.pdf: 4937949 bytes, checksum: c052666784bd930ac4748e41040c73bd (MD5) / Made available in DSpace on 2016-01-28T13:31:20Z (GMT). No. of bitstreams: 1 reis_afn_me_sjc.pdf: 4937949 bytes, checksum: c052666784bd930ac4748e41040c73bd (MD5) Previous issue date: 2015-12-15 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / O objetivo deste trabalho foi infiltrar sílica em uma cerâmica Y-TZP, avaliar seu efeito na resistência à flexão Biaxial, e na união com a porcelana feldspática. Para a análise da resistência à flexão foram confeccionados 180 discos de zircônia, 120 de 0,5mm e 60 com 1,2mm discos (14 mm de diâmetro). 90 discos foram infiltrados com sílica pelo método sol-gel em temperatura ambiente (n = 30). A espessura do disco foi de 1,2 mm para os espécimes controle (espécime sem porcelana, n = 30). O recobrimento por porcelana feldspática foi de duas espessuras (0,5mm e 1 mm) sobre a zircônia que tinha 0,5 mm. Os espécimes com porcelana foram polidos com lixas de carbeto de silício (SiC) de granulação # 400, 600, 800 e 1200. Obtivemos 6 grupos: dois monolíticos (ZR- Zircônia Monolítica sem infiltração e ZRI- Zircônia Monolítica Infiltrada) (controle) e quatro estratificados: ZRF 1,0 (0,5mm Zircônia coberta com 0,5 mm porcelana), ZRIF 1,0 (0,5 mm Zircônia infiltrada coberta com 0,5 mm de porcelana), ZRF 1,5 (0,5 mm Zircônia infiltrada coberta com 1,0 mm de porcelana) ZRIF 1,5- Zircônia infiltrada (0,5 mm Zircônia infiltrada coberta com 1,0 mm de porcelana). Após o ensaio de flexão biaxial em meio aquoso, foram determinados o módulo de Weibull (m) e resistência característica (σθ). Os fragmentos foram analisados em EDS, MEV, DRX e FTIR. A Dureza (H) e tenacidade a fratura foram analisadas pela nanoindentação, já o módulo elástico (E) por duas técnicas, nanoindentação e por impulso, e para avaliar a adesão entre a zircônia e a porcelana foi aplicado o Teste de Scratch. Foram modeladas 7 condições experimentais e analisados pelo método por elementos finitos. A zircônia monolítica infiltrada mostrou uma estrutura com grãos arredondados envoltos em uma matriz de sílica, e a presença de zircônia cúbica e tetragonal. O DRX revelou a formação de ZrSiO4 nos grupos infiltrados. Os grupos monolíticos apresentaram módulos de Weibull superiores aos dos grupos com porcelana. Com a análise (AEF) não houve diferença entre os grupos com a mesma espessura, já para o grupo recoberto com 0,5 mm de porcelana, os valores de tração e compressão foram maiores. A cerâmica infiltrada apresentou microestrutura diferente, e a adesão da porcelana à zircônia não-infiltrada foi superior à da zircônia infiltrada. / The objective was to infiltrate silica in a Y- TZP ceramics, evaluate its effect on resistance biaxial strenght, and the union with feldspathic porcelain. For the analysis of flexural strength were prepared zirconia discs 180, 120 and 60 of 0.5 mm to 1.2 mm disks (14 mm diameter). 90 discs were infiltrated with silica by the sol-gel method at room temperature (n = 30). The thickness of the disk was 1.2 mm for the samples control (no porcelain specimen, n = 30). The coating was feldspathic porcelain by two thicknesses (0.5 mm and 1 mm) of zirconia, which had 0.5 mm. Specimens with porcelain were polished with sandpaper silicon carbide (SiC) granulation # 400, 600, 800 and 1200. We obtained six groups: two monolithic (Zr-Zirconia Monolithic without infiltration and ZRI- Zirconia monolithic Infiltrated) (control) and four laminated ZRF 1.0 (0.5 mm zirconia covered with 0.5 mm porcelain), ZRIF 1.0 (0.5 mm infiltrated zirconia covered with 0.5 mm of porcelain), ZRF 1.5 (0.5 mm infiltrated zirconia covered with 1.0 mm of porcelain) ZRIF 1,5-infiltrated Zirconia (0.5 mm infiltrated zirconia covered with 1.0 mm of porcelain). After the biaxial bending test in an aqueous medium were determined Weibull modulus (m) and the characteristic strength (σθ). The fragments were analyzed by EDS, SEM, XRD and FTIR. The hardness (H) and fracture toughness were analyzed by nanoindentation, since the elastic modulus (E) by two techniques, nanoindentation and on impulse, and to evaluate the adhesion between the zirconia and porcelain was applied Scratch Test. 7 experimental conditions were modeled and analyzed by the finite element method. The infiltrated zirconia showed a monolithic structure with rounded grain wrapped in a silica matrix, and the presence of cubic and tetragonal zirconia. The XRD showed the formation of ZrSiO4 infiltrates in groups. The monolithic modules Weibull groups showed superior to porcelain groups. With the analysis (FEA) there was no difference between the groups with the same thickness, for now the group covered with 0.5 mm of porcelain, the tensile and compressive values were higher. The infiltrated ceramic showed different microstructure, and the accession of porcelain to non- infiltrated zirconia was higher than the infiltrated zirconia.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Objectives: (1) Compare the effects of grinding on a Y-TZP ceramic executed by diamond discs and diamond burs (with similar grit sizes) in the micromorphology of surface, phase transformation (t®m), flexural strength and structural reliability (Weibull analysis), (2) evaluate the effect of LTD (low-temperature degradation) in the outcomes mentioned above. Methods: Three hundred and sixty discs (15mm x 1,2 mm) of Y-TZP were made according to ISO 6872 2008 for flexural strength determination on ceramic materials and sintered according to the manufacturer`s instructions, than they were divided into groups according to two factors in study: surface treatment - 5 levels (without treatment, extra-fine diamond bur, 600-grit diamond disc, coarse diamond bur and 120-grit diamond disc) and LTD on 2 levels (with and without). For grinding with diamond discs a polishing machine was employed, while for grinding with diamond burs a device was employed to assure the perpendicularity between diamond tip and abrading surface, that way the abrasion movements and the applied pressure were standardized. The LTD was induced in an autoclave at 134ºC under 2 bar for 20 hours. Results: Our findings support that LTD although promoted increase in mphase content and micromorphological alterations did not promoted decrease in zirconia s mechanical properties, grinding at a first moment did not affected too, but when ground Y-TZP was submitted to the LTD effects, the defects introduced by grinding could be detrimental to the material`s resistance. From a methodological point of view, diamond discs should not be employed to simulate clinical abrasion performed with diamond burs on Y-TZP ceramics. Conclusion: Thus grinding of zirconia should be avoided and when it was really necessary tools with low grit sizes should be employed. / Objetivos: (1) Comparar os efeitos do desgaste da cerâmica Y-TZP gerados por lixas e pontas diamantadas (com granulações semelhantes) na micromorfologia da superfície, na transformação de fase (t®m), na resistência à flexão biaxial e confiabilidade estrutural (análise de Weibull), (2) Avaliar o efeito da LTD nos desfechos citados acima. Métodos: Trezentos e sessenta discos (15 mm x 1,2 mm) de Y-TZP foram confeccionados segundo as instruções da ISO 6872 2008 para ensaios de flexão em material cerâmico e sinterizados de acordo com as recomendações do fabricante, posteriormente foram divididos em grupos, de acordo com dois fatores em estudo: tratamento de superfície da cerâmica - 5 níveis (sem tratamento, disco de granulação 120, ponta diamantada de granulação super grossa, disco de granulação 600, ponta diamantada extra fina) e LTD - 2 níveis (sem e com). Para abrasão com lixas de diferentes granulações foi utilizada uma politriz, enquanto que para a abrasão com as pontas diamantadas foi utilizado um dispositivo que garantiu a perpendicularidade da ponta diamantada à superfície da amostra, padronizando os movimentos de abrasão e a pressão aplicada. A LTD foi realizada em autoclave sob 134° C à 2 bar por 20 horas. Resultados: Nossos achados suportam que a LTD embora promovesse aumento de fase monoclínica e alterações micromorfológicas não causou perda de propriedades mecânicas da zircônia, o desgaste em primeiro momento também não promoveu, mas quando esta superfície foi submetida aos efeitos da LTD, os defeitos introduzidos pelo desgaste podem ser prejudiciais a resistência do material. Sob um ponto de vista metodológico o uso de discos diamantados não deve ser empregado para simular o desgaste executado clinicamente com pontas diamantadas. Conclusão: Dessa forma o desgaste da superfície da zircônia deve ser evitado e quando necessário deve ser realizado com instrumentos de menor granulação.

Made available in DSpace on 2014-06-11T19:33:00Z (GMT). No. of bitstreams: 0 Previous issue date: 2006-07-28Bitstream added on 2014-06-13T19:43:56Z : No. of bitstreams: 1 casotti_ca_dr_araca.pdf: 660013 bytes, checksum: c630d7bb4fdb85d40a30ec52f8e05ca2 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / A fluoretação da água de abastecimento público é reconhecida como uma das principais estratégias de saúde pública para prevenir a cárie dentária. A cidade de Baixo Guandu, localizada no Estado do Espírito Santo, Brasil, foi a primeira a implantar o método. Foi objetivo do presente estudo avaliar o impacto que a fluoretação artificial da água proporcionou à saúde bucal de indivíduos com idade de 5, 12, 15 a 19, 20 a 34, 35 a 44 e 45 a 56 anos, que sempre viveram e consumiram exclusivamente água da rede de abastecimento público dos municípios de Baixo Guandu onde a fluoretação ocorre há 52 anos e Itarana, onde o método foi implantado há 3 anos. A metodologia, os códigos e os critérios adotados foram os recomendados pela Organização Mundial da Saúde (OMS), com a inserção dos grupos etários de 20 a 34 e 45 a 56 anos. Inicialmente foram identificados os moradores permanentes das duas cidades, as quais foram examinados no domicílio, com auxílio de espelho bucal e sonda periodontal CPI. Previamente à realização do estudo, o examinador passou por uma oficina de calibração e treinamento para a padronização dos diagnósticos da cárie dentária, fluorose dentária, perda dentária e uso e necessidade de prótese, em indivíduos com grupos etários semelhantes aos do estudo. Para o cálculo da concordância kappa intra-examinador, 10% dos indivíduos foram reexaminados, sendo os resultados obtidos para a cárie dentária 0,95; fluorose dentária 0,91; perda dentária 1 e o uso e necessidade de prótese 1. No total foram examinados 1588 moradores sendo 1129 (71,1%) de Baixo Guandu e 459 (28,9%) de Itarana. Foram utilizados os testes estatísticos Qui-quadrado, Fisher, Mann Whitney e de proporções com nível de significância de 5%. As médias do ceod aos 5 anos e CPOD aos 12, 15 a 19, 20 a 34, 35 a 44 e 45 a 56 anos foram, respectivamente, em Baixo Guandu... / The water fluoridation in the public supply is recognized as one of the main public health strategies to prevent dental caries. Baixo Guandu-ES was the first city to introduce this method in Brazil. The objective of the present study was to evaluate the impact that the artificial fluoridation of the water brought to the oral health of subjects in the age of 5, 12, 15 to 19, 20 to 34,35 to 44 and 45 to 56 years, that have always lived and consumed exclusively the water from the public supply of the city of Baixo Guandu for 52 years and Itarana where the method was introduced 3 years ago. The methodology, the codes and criteria adopted were recommended by the World Health Organization (WHO), with the insertion of age groups of 20 to 34 and 45 to 56 years. Initially the identification of the permanent inhabitants of both cities, was realized and they were locally examined with the aid of plan oral mirrors number 5 and CPI periodontal probes. Previously to this study, the examiner went through a calibrator's workshop and training for the diagnosis of dental caries, dental fluorosis, tooth loss, the use and need of prosthesis with age groups similar to the ones in the study. In order to have the Kappa's intra-examiner calculated, 10% of the individuals were re-examined and the obtained result for dental caries was 0.95; for dental fluorosis 0.91; for dental loss, and for the use and need for prosthesis 1. A total of 1588 inhabitants were examined, of those 1129 (71.1%) of Baixo Guandu and 459 (29.9%) of Itarana. The Chi-square, Fisher's, Mann-Whitney's and the Proportions tests with level of significance of 5% were used to verify the significant statistic of the results. The mean dmft for 5 year old subjects and DMFT for 12, 15 to 19, 20 to 34, 35 to 44 and 45 to 56 subjects were respectively in Baixo Guandu 2.32; 1,55; 3.48; 7.69; 13,85 and 16.49 and ...(Complete abstract, click electronic address below)

Orientador: Nemre Adas Saliba / Banca: Edgard Michel Crosato / Banca: Beatriz Unfer / Banca: Rogério Moreira Arcieri / Banca: Renato Herman Sundfeld / Resumo: A fluoretação da água de abastecimento público é reconhecida como uma das principais estratégias de saúde pública para prevenir a cárie dentária. A cidade de Baixo Guandu, localizada no Estado do Espírito Santo, Brasil, foi a primeira a implantar o método. Foi objetivo do presente estudo avaliar o impacto que a fluoretação artificial da água proporcionou à saúde bucal de indivíduos com idade de 5, 12, 15 a 19, 20 a 34, 35 a 44 e 45 a 56 anos, que sempre viveram e consumiram exclusivamente água da rede de abastecimento público dos municípios de Baixo Guandu onde a fluoretação ocorre há 52 anos e Itarana, onde o método foi implantado há 3 anos. A metodologia, os códigos e os critérios adotados foram os recomendados pela Organização Mundial da Saúde (OMS), com a inserção dos grupos etários de 20 a 34 e 45 a 56 anos. Inicialmente foram identificados os moradores permanentes das duas cidades, as quais foram examinados no domicílio, com auxílio de espelho bucal e sonda periodontal CPI. Previamente à realização do estudo, o examinador passou por uma oficina de calibração e treinamento para a padronização dos diagnósticos da cárie dentária, fluorose dentária, perda dentária e uso e necessidade de prótese, em indivíduos com grupos etários semelhantes aos do estudo. Para o cálculo da concordância kappa intra-examinador, 10% dos indivíduos foram reexaminados, sendo os resultados obtidos para a cárie dentária 0,95; fluorose dentária 0,91; perda dentária 1 e o uso e necessidade de prótese 1. No total foram examinados 1588 moradores sendo 1129 (71,1%) de Baixo Guandu e 459 (28,9%) de Itarana. Foram utilizados os testes estatísticos Qui-quadrado, Fisher, Mann Whitney e de proporções com nível de significância de 5%. As médias do ceod aos 5 anos e CPOD aos 12, 15 a 19, 20 a 34, 35 a 44 e 45 a 56 anos foram, respectivamente, em Baixo Guandu ...(Resumo completo, clicar acesso eletrônico abaixo) / Abstract: The water fluoridation in the public supply is recognized as one of the main public health strategies to prevent dental caries. Baixo Guandu-ES was the first city to introduce this method in Brazil. The objective of the present study was to evaluate the impact that the artificial fluoridation of the water brought to the oral health of subjects in the age of 5, 12, 15 to 19, 20 to 34,35 to 44 and 45 to 56 years, that have always lived and consumed exclusively the water from the public supply of the city of Baixo Guandu for 52 years and Itarana where the method was introduced 3 years ago. The methodology, the codes and criteria adopted were recommended by the World Health Organization (WHO), with the insertion of age groups of 20 to 34 and 45 to 56 years. Initially the identification of the permanent inhabitants of both cities, was realized and they were locally examined with the aid of plan oral mirrors number 5 and CPI periodontal probes. Previously to this study, the examiner went through a calibrator's workshop and training for the diagnosis of dental caries, dental fluorosis, tooth loss, the use and need of prosthesis with age groups similar to the ones in the study. In order to have the Kappa's intra-examiner calculated, 10% of the individuals were re-examined and the obtained result for dental caries was 0.95; for dental fluorosis 0.91; for dental loss, and for the use and need for prosthesis 1. A total of 1588 inhabitants were examined, of those 1129 (71.1%) of Baixo Guandu and 459 (29.9%) of Itarana. The Chi-square, Fisher's, Mann-Whitney's and the Proportions tests with level of significance of 5% were used to verify the significant statistic of the results. The mean dmft for 5 year old subjects and DMFT for 12, 15 to 19, 20 to 34, 35 to 44 and 45 to 56 subjects were respectively in Baixo Guandu 2.32; 1,55; 3.48; 7.69; 13,85 and 16.49 and ...(Complete abstract, click electronic address below) / Doutor

Os orifícios de acesso aos parafusos de retenção devem ser preenchidos para que o parafuso não seja danificado caso seja necessária a remoção da prótese. Dentre os materiais mais utilizados estão o algodão, a fita de politetrafluoretileno e a guta percha. O objetivo deste estudo é avaliar a formação de biofilme de Candida albicans nos materiais anteriormente descritos, buscando estabelecer um parâmetro que contribua para a escolha do tipo de material mais adequado a ser utilizado clinicamente. Foram utilizados UCLAs, análogos e parafusos sextavados, todos de titânio. Os conjuntos foram montados com torque de 32N. Os materiais foram condensados no interior dos UCLAs e colocados em meio de cultura com uma suspensão de 3x106 células/ml de Candida albicans. O sistema foi armazenado à 37C com agitação, por 15 dias e o meio foi renovado a cada 48 horas. A quantificação de biofilme foi realizada pelo ensaio de MTT e leitura à 490nm, resultando em diferentes valores de densidade óptica. A normalidade (p=0,304 - Kolmogorov-Smirnov) e a igualdade de variâncias (p=0,721 - Scheffe) foram testadas primeiramente. O teste de análise de variância demonstrou diferença significativa entre os grupos (p<0,001) e com o Holm-Sidak foi observada diferença significativa entre os grupos algodão e guta (p<0,05) e algodão e fita de politetrafluoetileno (p<0,05); não houve diferença significativa entre os grupos guta e fita de politatrafluoretileno (p>0,05), apesar dos valores da fita de politetrafluoetileno terem sido maiores. Considerando-se as limitações deste estudo in vitro, podemos concluir que tanto a guta-percha quanto a fita de politetrafluoretileno apresentaram menor formação de biofilme, não havendo diferença estatisticamente significativa entre os materiais. O algodão apresentou um nível de formação de biofilme significativamente maior que a fita de politetrafluoretileno e a guta percha. Diante disso, serão necessários novos estudos para confirmar as limitações que este tipo de material pode apresentar quando usado como material de preenchimento do acesso do parafuso da prótese sobre implante. / The access holes for fixing screws in prostheses on implants must be completed so that the screw is not damage if is necessary to remove the prostheses. Among the most common materials used are cotton, gutta percha and polytetrafuoroetylene tape. The aim of this study is to evaluate the biofilm formation in the materials described above, in order to establish a parameter that contributes to the choice of most suitable material. We used UCLAs, similar (4,1 mm) and titanium screws. The set was assembled with a torque of 32 N.cm. The materials were condensed inside the UCLAs and placed in culture medium with suspension of 3x 106 cells/ml of Candida albicans. The system was stored at 37 o C with shaking for 15 days and renewed every 48 hours. The quantification of biofilm was performed by MTT assay at 490 nm and reading. Analyzed the normal (p=0,304-Kolmogorov-Smirnov) and equal variances (p= 0,721- Scheffe). The ANOVA showed significant difference between groups (p<0,001) and Holm- Sidak significant difference was observed between the cotton and gutta groups (p<0,05) and cotton and PTFE (p<0,05), not significant difference between groups gutta and polytetrafuoroetylene tape (p>0,05), although values were higher polytetrafuoroetylene tape. Considering the limitations of this in vitro study, we conclude that:1. Both gutta-percha and polytetrafluorethylene tape showed less biofilm formation, with no statistically significant difference between the materials. 2. Cotton showed a level of biofilm formation significantly higher than the polytetrafluoroethylene tape and gutta percha. Therefore, further studies are necessary to confirm the limitations that this type of material can have when used as filling material of the screw access on the prosthetic implant.

Abstract Oral health among older people is shown to be worse compared to younger people. The aim of this study was to evaluate oral health and associating factors among ageing Finns. A cross-sectional, descriptive epidemiologic survey was performed in Kirkkonummi in southern Finland and in the Lakeus District in northern Finland. Altogether 1,191 subjects aged 60 to 78 years, 625 from Kirkkonummi and 566 from Lakeus, were examined and interviewed. Edentulousness and poor occlusal stability were recorded clinically. Gonial angle, ramus height, condylar height and the amount of residual ridge resorption in the mandible and the presence of fixed prostheses were evaluated from panoramic radiographs. Based on the radiographs the scoring of infection foci was performed with an infection focus index. The signs of infection recorded were deep caries, periapical lesions, furcal lesions, vertical bone pockets and horizontal bone loss. The prevalence of edentulousness was 37%, being significantly higher among women than among men and significantly higher in the northern compared to the southern region. Edentulousness was more prevalent among subjects with primary school education than among those with higher education. The mean of the gonial angle was smaller among dentate subjects than among edentulous ones. Dentate subjects had significantly greater ramus height and condylar height than edentulous subjects. Women had significantly more often than men severe residual ridge resorption in the mandible. Poor satisfaction with dentures associated significantly with poor occlusal stability in both genders. More than three quarters of the subjects had severe risk of infection, more in the southern than in the northern region. In the dentate sample women showed higher prevalence of fixed prostheses than men. In the Kirkkonummi region both men and women had more fixed prostheses than subjects in the Lakeus region. Edentulousness was very frequent among ageing Finns. Mandibular bone morphology changed as a consequence of tooth loss. The prevalence of fixed prostheses was low and the prevalence of signs of infection of dental origin was high. The geographical differences in oral health should be considered by health authorities in order to promote good oral health in rural areas, especially focusing on older people with low socio-economical status and poor health. / Tiivistelmä Vanhusväestön suun terveydentila on useassa tutkimuksessa todettu huonommaksi kuin nuoremmilla. Tämän tutkimuksen tarkoituksena oli selvittää suomalaisen ikääntyvän väestön suun terveydentilaa ja siihen liittyviä tekijöitä. Epidemiologinen poikkileikkaustutkimus tehtiin Kirkkonummella Etelä-Suomessa ja Lakeuden terveyskeskuksen alueella Pohjois-Suomessa. Tutkimukseen ja haastatteluun osallistui yhteensä 1191 iältään 60–78-vuotiasta henkilöä, 625 Kirkkonummelta ja 566 Lakeudelta. Kliinisessä tutkimuksessa selvitettiin hampaattomuus ja proteesien purentatasapaino. Alaleuan leukakulma, nousevan haaran ja nivellisäkkeen korkeus, hammasharjanteen korkeus ja kiinteiden proteesien esiintyminen arvioitiin panoraamaröntgenkuvista. Tulehdusriskiä kuvaava indeksi arvioitiin röntgenkuvien tulehdusmuutoksista, joina rekisteröitiin syvä karies, hampaan juurenpään tulehdus, tulehdus takahampaiden juurten haarautumassa, syventyneet luutaskut ja kiinnityskudoskato usean hampaan alueella. Hampaattomuuden vallitsevuus oli 37 %. Se oli tilastollisesti merkitsevästi korkeampi naisilla kuin miehillä ja pohjoisella alueella merkitsevästi korkeampi kuin eteläisellä. Hampaattomuus oli yleisempää vähiten koulutusta saaneilla kuin korkeamman koulutuksen saaneilla. Hampaallisilla oli pienempi alaleuan leukakulma kuin hampaattomilla, ja heillä oli myös korkeampi nouseva haara ja nivellisäke kuin hampaattomilla. Naisilla oli merkitsevästi useammin vakavaa hammasharjanteen madaltumista kuin miehillä. Molemmilla sukupuolilla tyytymättömyys proteeseihin liittyi merkitsevästi huonoon purentatasapainoon. Yli kolmella neljäsosalla tutkituista oli vakava tulehdusriski, eteläisellä alueella enemmän kuin pohjoisella. Hampaallisessa aineistossa naisilla oli enemmän kiinteitä proteeseja kuin miehillä. Kirkkonummen alueella tutkituilla oli enemmän kiinteitä proteeseja kuin Lakeuden alueella. Hampaattomuus oli hyvin yleistä 60–78-vuotiailla suomalaisilla. Alaleuanluun muoto muuttui hampaiden menetyksen seurauksena. Kiinteiden proteesien määrä oli vähäinen ja ikääntyvillä suomalaisilla oli röntgenkuvissa runsaasti hammasperäisten tulehdusten löydöksiä. Suun terveyden alueelliset erot tulisi ottaa huomioon suu- ja hammasterveyden edistämistyössä, jossa erityisesti tulisi huomioida alhaisen sosioekonomisen aseman ja huonon terveyden omaava vanhempi väestö.