Thesis (doctoral)--University of Lund, 1980. / Extra t.p., with thesis statement, inserted. Includes reprints of ten supporting articles published in various scientific journals. Includes bibliographical references.

Orientador: Frederico Andrade e Silva / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-15T02:02:50Z (GMT). No. of bitstreams: 1 Alves_MarcelaRodrigues_D.pdf: 3962410 bytes, checksum: f9ab6a09265ef5789e38c0c28c3e6e4e (MD5) Previous issue date: 2009 / Resumo: O objetivo desta pesquisa foi avaliar a relação entre a morfologia crânio-facial, o espaço aéreo faríngeo, a posição do osso hioide e a postura crânio-cervical. Foram realizadas radiografias cefalométricas de perfil de 52 voluntários em posição natural, na faixa etária entre 18 e 28 anos, de ambos os gêneros, selecionados aleatoriamente, que não apresentassem histórico de tratamento ortodôntico, ausências de dentes (exceto os terceiros molares), presença de anomalias de crescimento ou desenvolvimento do esqueleto craniofacial (exceto prognatismo e retrognatismo), uso de qualquer tipo de aparelho oclusal e voluntários com amaurose (perda visual total) ou fonoaudiológicas graves. Foram obtidas medidas lineares e angulares da morfologia crânio-facial, do espaço aéreo faríngeo, da posição do osso hioide e da postura crânio-cervical. Os dados coletados foram agrupados e as variáveis relacionadas pela Correlação Linear de Pearson (a=0,05). A posição anteroposterior do osso hioide apresentou maior relação com o comprimento do corpo mandibular (r=0,50) e comprimento (r=0,62) e área intermaxilar (r=0,57), todos com p<0,01, porém foi detectada fraca relação com a inclinação da coluna cervical (r=-0,28; p<0,05). Sua posição superoinferior estava relacionada (p<0,01) com a altura facial anterior (r=0,79) e a altura do terço inferior da face (r=0,63). A inclinação do osso hióide apresentou relação com o eixo de crescimento (r=0,39; p<0,01), porém essa variável apresentou relação mais forte com a postura crânio-vertical (r=0,58; p<0,01) e crâniocervical (r=0,57; p<0,01). A distância do osso hioide à sínfise mandibular apresentou relação significativa (p<0,01) com a postura crânio-cervical (r=0,52) e cervical (r=-0,44). As posturas crânio-vertical e crânio-cervical apresentaram considerável relação (p<0,01) com o ângulo SNB, inclinação mandibular e com o eixo de crescimento. Não foi observada nenhuma relação entre a postura crânio-cervical e o espaço aéreo faríngeo. O diâmetro oro e hipofaríngeo apresentaram considerável relação (p<0,01) com o comprimento (r=0,67) e área intermaxilar (r=0,42) e com o eixo de crescimento (r=-0,50). Esses espaços apresentaram também relação significativa com a posição anteroposterior do osso hioide e com a distância deste a sínfise mandibular, sendo mais forte ainda, a relação com o espaço aéreo hipofaríngeo (r=0,59 e r=0,52, respectivamente; p<0,01). Pode-se observar que existe uma grande interação morfofuncional entre as estruturas da cabeça e pescoço. O conhecimento destas relações é importante, quando se pretende realizar alguma intervenção capaz de alterar o equilíbrio entre elas ou ainda que se proponha a corrigir a ausência deste. / Abstract: The aim of this research was to evaluate the relation between the craniofacial morphology, pharyngeal airway space, the hyoid bone position and the craniocervical posture. Lateral cephalometric radiographs were obtained from 52 volunteers in natural head posture, among 18 and 28 years old, of both genders, randomly selected, that had not historical of orthodontic treatment, tooth absences (except the third molar ones), presence of growth or development anomalies of the craniofacial skeleton (except prognathism and retrognathism), use of any type of occlusal appliance and volunteers with amaurosis (visual loss) or serious phonoaudiological deficiencies. Linear and angular measurements referring to the craniofacial morphology, pharyngeal airway space, hyoid bone position and craniocervical posture had been taken. The collected data were grouped and the variables had been related by means of Pearson Linear Correlation (a=0.05). The hyoid bone anteroposterior position showed greater relation with the mandibular body length (r=0.50) and intermaxilary length (r=0.62) and area (r=0.57), both with p<0.01, besides it showed a weak relation with cervical column inclination (r=-0.28; p<0.05). The hyoid bone superoinferior position was strongly related (p<0.01) with the total anterior facial height (r=0.79) and facial lower third height (r=0.63). The hyoid bone inclination presented relation with the growth axis (r=0.39; p<0.01), however this variable presented strongest relation with the cranio-vertical (r=0.58; p<0.01) and cranio-cervical (r=0.57; p<0.01) postures. The hyoid bone to mandibular synphysis distance presented significant relation (p<0.01) with the cranio-cervical (r=0.52) and cervical (r=-0.44) posture. The craniovertical and cranio-cervical postures presented considerable relation (p<0.01) with prognathism, mandibular inclination and with the growth axis. It was not seen any relation between cranio-cervical posture and pharyngeal airway space. The oropharynx and lower pharyngeal diameter presented considerable relation (p<0.01) with the intermaxilary length (r=0.67) and area (r=0.42) and with the growth axis (r=-0.50). These spaces still presented significant relation with the hyoid bone anteroposterior position and with the hyoid bone to mandibular synphysis distance, being strongest to the lower pharyngeal space (r=0.59 and r=0.52, respectively; p<0.01). It could be observed that a great morphofunctional interaction exists between the head and neck structures. The knowlegd of these relations is important, when it is intend to do some intervention that is able of modify this balance or when the intention is correct an unbalance. / Doutorado / Protese Dental / Doutor em Clínica Odontológica

No description available.

published_or_final_version / Dentistry / Doctoral / Doctor of Philosophy

Estudos epidemiológicos regionais que envolvam a traumatologia maxilofacial são importantes para auxiliar o desenvolvimento de formas mais eficientes de prestar cuidados em saúde, para avaliar e melhorar a qualidade destes cuidados e gerenciar estratégias de prevenção, financiamento e acesso ao tratamento no setor público de saúde. O tempo decorrido entre um trauma de face de um paciente até o atendimento clínico e tratamento das fraturas pode afetar os resultados clínicos em termos de intervenções resolução e complicações. O objetivo deste estudo foi verificar se no Hospital Público Eugênio Espejo de Quito, existe uma relação entre variáveis de tipificação das fraturas, seus tratamentos e os intervalos de tempo para sua resolução clínica com o aparecimento de complicações. Um estudo retrospectivo foi realizado nos prontuários do Serviço de Cirurgia bucomaxilofacial veificando dados epidemiológicos e da evolução clínica de pacientes que sofreram fraturas em face, esqueleto fixo e mandíbula entre os anos de 2012 e 2016. Os resultados mostraram que a epidemiologia das fraturas faciais foi bastante semelhante ao que a literatura pertinente ao assunto tem mostrado. A maioria dos casos ocorreram fora da cidade de Quito (64%). Observamos que não existe associação das variáveis: histórico de hábitos nocivos, presença de desvio, tipo de fratura, abordagem da fratura, tipo de fixação, presença ou não de comorbidades com o aparecimento de fraturas. Entretanto, os dados mostraram que existe 70% mais chances de risco de complicações quando o intervalo decorrido entre o acidente e o tratamento definitivo ultrapassar uma semana. Discutimos os fatores que podem implicar neste maior intervalo de tempo entre essas condutas e concluímos que existe a necessidade de investimento na especialidade e estudos para implantação de novos serviços fora da cidade de Quito. / Regional epidemiological studies involving maxillofacial traumatology are important to assist in the development of more efficient ways of providing health care, to assess and improve the quality of these care and to manage strategies of prevention, funding and access to treatment in public health sector. The time elapsed between a trauma of a patient\'s face until clinical care and treatment of fractures can affect the clinical results in terms of resolution interventions and complications. The objective of this study was to check whether in the public hospital Eugenio Espejo de Quito, there is a relationship between variables of typing of the fractures, their treatments and the intervals of time for their clinical resolution with the appearance of complications. A retrospective study was performed in the records of the Maxillofacial Surgery Service to verify epidemiological data and clinical evolution of patients who suffered fractures in face, fixed skeleton and jaw, between 2012 and 2016. The results showed that epidemiology of the facial fractures was quite similar to what pertinent literature to the subject has shown. Many of the cases occurred out city of Quito (64%). We observe that there is no association of historical variables of harmful habits, presence of deviation, type of fracture, approach of fracture, type of fixation, presence or not of comorbidities with the appearance of complications. However, the data showed that there are 70% more chances of risk of complications when the interval elapsed between the accident and the definitive treatment exceed one week. We discuss the factors that can be associated with the largest interval of time between conducts and we conclude that there is a need for investment in the specialty and studies for implementation of new services out the city of Quito.

A recuperação de partes deficientes do corpo humano por substitutos funcionais, tem suscitado questionamentos por parte de profissionais cirurgiões e pesquisadores da área de cirurgia e traumatologia Bucomaxilofacial. Na tentativa de recuperar o contorno anatômico natural e restaurar a função de áreas com deficiência de tecido ósseo, optou-se inicialmente pela utilização de enxertos ósseos autógenos. Apesar de suas inúmeras vantagens, o uso de enxertos autógenos na reconstrução da face apresenta certos inconvenientes, como a necessidade de hospitalização, intervenção em outra área do organismo, morbidade da área doadora, maior período de convalescença, susceptibilidade a infecções, e ainda, uma possível reabsorção progressiva e constante. Um questionamento ainda maior gira em torno das cirurgias para enxerto ósseo na face já que os ossos da face são curtos e não justifica a morbidade de uma outra região do organismo para suprir sua necessidade. Na tentativa de substituir o uso de enxertos autógenos, cirurgiões começaram a optar por materiais sintéticos ou similares orgânicos, associadas com o uso das proteínas ósseas morfogenéticas, que são fatores de crescimento responsáveis pela indução da formação óssea no organismo humano desde sua fase fetal até a idade madura. A proposta deste estudo é fazer uma avaliação sobre o conhecimento e o uso clínico pelos cirurgiões buco-maxilo-faciais, no Brasil, de proteínas ósseas morfogenéticas no auxílio à reparos de defeitos ósseos da face. / The use of alloplastic materials for bone replacement has been extensively debated lately by surgeons and researchers in the Oral and Maxillofacial field. In the attempt to reconstruct bone defects anatomically and functionally autogenous bone grafts have been the preferred option. Although being considered the gold standard in craniofacial reconstruction, there are some inconveniences in the use of bone autografts. Among them the need of hospitalization, the need of a donor site usually in a different area than the bone defect, donor area morbidity, longer recovery time, increased risk of infection, and the possibility of bone resorption over time. When the face is operated the use of autogenous bone is even more questionable. Usually small amounts of bone grafts are necessary in the face, and might not justify the morbidity of the donor site. In an attempt to avoid the use of bone autografts, allografts and alloplastic materials have been advertised, in association with bone morphogenetic proteins. These proteins are growth factors involved in the osteogenesis in humans from the fetus up to the adult age. The aim of this study is to evaluate the knowledge and the clinical use of bone morphogenetic proteins in the repair of facial bone defects by Brazilian Oral and Maxillofacial surgeons.

Typescript (Photocopy) / Bibliography: leaves 243-284 / 284 leaves : / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Thesis (M.D.)--Dept. of Surgery, University of Adelaide, Dept. of Surgery, 1992

Bone loss from the cranio-maxillofacial region is a major clinical problem affecting patients worldwide. Conventional treatment strategy includes the use of autogenous or allogeneic bone, biomaterials, and osteogenic growth factors. However, there has been no effective therapy for most cases so far. Stem cell-based gene therapy is the latest research method with possible applications in humans. The present study aims to (1) characterize rabbit mesenchymal stem cells (MSCs) relating to growth pattern, surface antigens, and the potential for multi-differentiation; (2) determine the transduction efficiency and duration of recombinant adeno-associated virus2 carrying enhanced green fluorescent protein (rAAV2EGFP) reporter gene in rabbit MSCs and study the effects of rAAV2EGFP transduction on stem cells’ phenotype and capacity of multi-differentiation; (3) evaluate the differentiation characteristics of rabbit MSCs following recombinant adeno-associated virus 2 carrying bone morphogenetic protein 2 gene (rAAV2BMP2) transduction; (4) investigate whether MSCs transduced by rAAV2BMP2 could successfully induce bone regeneration in rabbit critical-size cranial defects. MSCs were isolated from bone marrows of rabbit tibias and cultured. Cell counting and colony-forming assays demonstrated that growth rates of MSCs dropped substantially with increasing passages. Flow cytometry on MSCs at passage 1 showed that cells expressed high level of CD49a and low level of CD44 as well as stage-specific embryonic antigen 4 (SSEA4). Multi-differentiation and reverse transcriptase-polymerase chain reaction (RTPCR) tests demonstrated that rabbit MSCs were capable to differentiate into osteocytes, chondrocytes and adipocytes. Immunofluorescence microscopy showed that rabbit MSCs produced a series of hematopoietic growth factors, including stem cell factor (SCF), vascular endothelial growth factor-A (VEGFA) and granulocyte macrophage colony-stimulating factor (GMCSF). Subsequently, rabbit MSCs were transduced with rAAV2EGFP in vitro. By comparing the transduction efficiency with different doses of rAAV2EGFP particles, multiplicity of infection (MOI) of 1 x 10 4 was identified as an optimal parameter for the transduction of rAAV2 in rabbit MSCs. Fluorescent microscopy demonstrated long-term expression of EGFP in rabbit MSCs after transduction both in vitro and in vivo. In addition, cell proliferation assay, adipogenic induction test and flow cytometry showed that rAAV2EGFP transduced MSCs exhibited a similar pattern with non-transduced cells on the cell growth, capacity of adipogenic differentiation and expression of surface antigens, indicating that rabbit MSCs maintain their stem cell properties after rAAV2EGFP transduction. / published_or_final_version / Dentistry / Doctoral / Doctor of Philosophy

Objectives: To report the incidence of objective and subjective neurosensory disturbance (NSD) after orthognathic surgery in a major orthognathic centre in Hong Kong, and to investigate the risk factors that contributed to the incidence of NSD after orthognathic surgery. Materials and Methods: A retrospective cross-sectional study on NSD after orthognathic surgery in a local major orthognathic centre. Patients who had bimaxillary orthognathic surgery reviewed at post-operative 6 months, 12 months or 24 months were recruited to undergo a neurosensory test with subjective and 3 objective assessments. Possible risk factors of NSD including subjects’ age and gender, surgical procedures and surgeons’ experience were analyzed. Results: 238 patients with 476 sides each of maxillary and mandibular procedures were recruited. The incidences of subjective NSD after maxillary procedures were 16.2%, 13% and 9.8% at post-operative 6 months, 12 months and 24 months, respectively; the incidences of subjective NSD after mandibular procedures were 35.4%, 36.6% and 34.6% at post-operative 6 months, 12 months and 24 months, respectively. Objective neurosensory tests showed general reduced sensitivity in subjects with subjective NSD. Increased age was found to be a significant risk factor of NSD after orthognathic surgery at short term (at 6 months and 12 months) but not at 24 months. SSO has a significantly higher risk of NSD when compared to VSSO. SSO in combination with anterior mandibular surgery has a higher risk of NSD when compared to VSSO in combination with anterior mandibular surgery or anterior mandibular surgery alone. Gender of patients a nd surgeons’ experience were not found to be risk factors of NSD after orthognathic surgery. Conclusion: The incidence of NSD after maxillary and mandibular orthognathic procedures at post-operative 6 months, 12 months and 24 months was reported. Increased age was identified as a risk factor of short term post-operative NSD but not in long term (24 months or more). Specific mandibular procedures were related to higher incidence of NSD after orthognathic surgery. / published_or_final_version / Dental Surgery / Master / Master of Dental Surgery

Thesis (M.S.)--University of Michigan, 1960.