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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

Diabetes mellitus is a metabolic disease with abnormally high concentration of glucose in blood in patients. Continuous glucose monitoring, which involves measuring glucose concentration in the patient throughout the day and night, can significantly reduce the risk of diabetes-related complications. Commercially available CGM sensors are not yet suited for long-term applications due to reliability and accuracy issues associated with the irreversible, consumptive nature of the underlying electrochemical reactions. Affinity sensing methods, which are based on reversible affinity binding between glucose and a recognition molecule, hold the potential to address these challenges in CGM applications. These methods do not involve the consumption of glucose and can offer improved stability and accuracy for CGM. When combined with impedance-based transduction methods, affinity sensors can also offer a high level of miniaturization, allow low-cost instrumentation, and are amenable to physical and functional integration. The affinity sensors investigated in this thesis include hydrogel-based affinity microsensors and graphene-based affinity nanosensors. We first present a dielectric affinity microsensor that consists of a pair of coplanar electrodes functionalized in situ with a glucose-responsive hydrogel for dielectrically based affinity measurement of glucose in subcutaneous tissue. We present a study of the effects of the choice of hydrogel compositional parameters on the characteristics of the hydrogel-based microsensor, allowing the identification of the optimal hydrogel composition for the microsensor to sensitively and rapidly respond to changes in glucose concentration. A differential design is then demonstrated, both in vitro and in vivo, to effectively minimize the influence of fluctuations in the environmental conditions, thereby allowing the hydrogel-based microsensor to function appropriately as a subcutaneously implanted device. In addition, we present a preliminary study on affinity nanosensors for non-invasive monitoring of glucose concentrations in physiological media such as tears. The affinity nanosensor is based on a chemically modified graphene field-effect transistor for the electrical measurement of glucose concentrations. The study explores the sensing mechanism of the nanosensors and demonstrates a device with high sensitivity and low limit of detection, which satisfies the requirement for monitoring glucose concentrations in tears. Experimental results demonstrate that these affinity micros and nanosensors are capable of measuring glucose concentrations with a suitable sensitivity and dynamic range for the intended physiological media, with potential applications to minimally invasive or non-invasive continuous glucose monitoring in diabetes care.

In most classrooms, where information is presented orally via spoken language, accurate knowledge of a student's hearing status is crucial so that the interdisciplinary team can ensure appropriate service provision. Audiologists play a key role on the interdisciplinary team to provide other professionals with information about children's hearing status, communication needs, device use, and intervention strategies. Conversely, audiologists gain valuable information and strategies from other team members.

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.

Among the prosthetic and implant biomaterials in the oral cavity currently exciting tremendous interest, titanium and resin are the main components of implants and dentures respectively. From their introduction in the oral cavity, a highly complex heterogeneous biofilm coats these biomaterials. The present thesis analyzes the complex relationships that are formed between one single microorganism (Candida albicans), one defence system of the oral cavity (oral peroxidases) and the two aforementioned biomaterials (titanium and resin). These biomaterials are indeed in contact with peroxidases: myeloperoxidase from neutrophils and sialoperoxidase from salivary secretions. Oral peroxidases belong to the salivary non immune innate defence mechanisms that control the oral microbial flora. In the presence of hydrogen peroxide (H2O2), they catalyze in vivo the oxidation of thiocyanate (SCN-) into hypothiocyanite (OSCN-), in vitro the oxidation of iodide (I-) into hypoiodite (OI-). In the salivary compartment and in oral biofilms, H2O2 is mainly formed by bacteria. In our investigations, H2O2 was produced by an enzyme sequence glucose (G) / glucose-oxidase (GOD). The OSCN- and OI- are antibacterial, antiviral and antifungal oxidants. Few studies have considered their action on Candida biofilms.<p>Candida albicans is a commensal yeast of the oral cavity which can turn parasitic when the host immune defences are weakened. This fungus forms biofilms on biomaterials within the mouth, especially on dentures, the decontamination of these prostheses is therefore essential to avoid the risk of candidosis. (Candida et prothèses dentaires. Ahariz M. Loeb I. Courtois Ph. Rev. Stomatol. Chir. Maxillofac. 111: 74-78, 2010).<p>In vitro, our investigations aimed to analyze the relationships between peroxidase systems and Candida. The effect of peroxidase systems (G / GOD / KI or KSCN / peroxidase) on Candida suspensions, on biofilms already formed or in formation was evaluated with various inputs of hydrogen peroxide and was studied by incorporation of enzymatic sequences in the culture media used for Candida biofilms formation. The susceptibility of Candida albicans ATCC 10231 to OSCN- versus to OI-, produced by lactoperoxidase (LPO), was studied in three different experimental models: - in a liquid culture medium – on a solid medium (with agarose gel), - in a biofilm model developed in the context of this work. The latter consisted of titanium powder suspended in Sabouraud broth contaminated with Candida albicans. The growth of Candida in the supernatant (planktonic phase) was evaluated by turbidimetry and the biomass of yeasts adherent to biomaterials (attached phase) by the tetrazolium salt MTT method. Enzymatic studies have allowed the optimization of the concentrations and activities of peroxidase systems components and the illustration of the competition between thiocyanate and iodide for lactoperoxidase. Peroxidase systems G/GOD/I-/LPO and G/GOD/SCN-/LPO prevented or limited the growth of Candida in the planktonic and attached phases on titanium powder for at least 21 days. At a dose of GOD (0.2 U / ml), the system G/GOD/I-/LPO has limited the development of planktonic and attached phases for 4 days while the system G/ GOD/SCN-/LPO has shown an inhibitory effect only in the first 2 days of incubation. (Candida albicans susceptibility to lactoperoxidase-generated hypoiodite. Ahariz M. Courtois Ph. Clinical, cosmetic and investigational dentistry; 2: 69-78, 2010).<p>In other experiments, peroxidase was adsorbed on titanium sheets in order to modify their surface and give them the property of inhibiting biofilm formation of Candida after addition of the enzyme substrates. Enzymatic studies and X-ray photoelectron spectroscopy (XPS) showed the adsorption of lactoperoxidase to titanium. In vivo, peroxidases are adsorbed on titanium healing abutments. (Adsorption of peroxidase on titanium surfaces: A pilot study. Ahariz M. Mouhyi J. Louette P. Van Reck J. Malevez C. Courtois P. J. Biomed. Mater. Res. 52: 567-571, 2000).<p>The development of the Candida biofilm was followed on titanium (powder or sheets) as well as on resin. Planktonic and attached phases have been monitored for 21 days. The presence of an exopolysaccharide matrix secreted by the yeasts has been observed with light microscopy and confirmed with fluorescence using the calcofluor method. In a series of experiments on titanium and resin sheets, an attached phase was demonstrated by the same techniques. The efficiency of the peroxidase system using iodide as a substrate was demonstrated when the enzyme was in solution and when it was preadsorbed on titanium (Candida albicans biofilm on titanium: effect of peroxidase precoating. Ahariz M. Courtois Ph. Medical Devices: Evidence and Research; 3: 33-40, 2010).<p>The incorporation in oral gels of other molecules present in exocrine secretions is a research direction that was also discussed: the present studies have demonstrated the in vitro benefits of peroxidase systems (with thiocyanate, chloride or especially iodide as substrates) acting in synergy with colostrum, lactoferrin and lysozyme. But the formulation of specialities that contain these natural antimicrobials is difficult to transpose in vivo as the complexity of the oral environment is very large (Denture contamination by yeasts in the elderly. Vanden Abbeele A. de Meel H. Ahariz M. Perraudin J.-P. Beyer I. Courtois P. Gerodontology; 25: 222-228, 2008).<p>Investigations pursued in vivo in 155 patients allowed the determination of the wild strains of Candida sp present on the fitting surface of the removable dental appliance and on the corresponding palatal mucosa. The link between the presence of yeasts and a reduced salivary flow was confirmed. These wild strains were directly grown and identified on Petri dishes (ChromAgar™ medium) from the macroscopic morphology of colonies and from additional tests (germination test in human serum, formation of chlamydoconidies on RAT medium, API™ galleries identification system ). For a period of two weeks, 14 patients accepted the daily application of a gel on the fitting surface of their denture. It was a double-blind comparison of an active gel containing the thiocyanate - lysozyme - lactoferrin - colostrum complete system with a control gel inactivated by heating. Data analysis showed a reduction in the number of colonies on the palatal mucosa by Candida sp, but not on the denture itself. By contrast, decontamination ex vivo of dentures by immersion in a bath (at room temperature or 37° C) containing either G/GOD producing H2O2 or the complete peroxidase system G/GOD/KI/L producing OI- demonstrated the efficiency of hypoiodite.<p><p><p>Parmi les biomatériaux prothétiques et implantaires qui connaissent actuellement un essor considérable dans la sphère orale, le titane est le composant principal des implants et la résine celui des prothèses dentaires. Dès leur introduction dans la cavité orale, un biofilm hétérogène très complexe les recouvre. Cette thèse analyse la complexité des relations qui se nouent entre un seul micro-organisme (Candida albicans), un système de défense de la cavité orale (les peroxydases orales) et les 2 biomatériaux précités (titane, résine). Ces biomatériaux sont en effet, dans le milieu oral, au contact de peroxydases: la myéloperoxydase des neutrophiles et la sialoperoxydase des sécrétions salivaires. Les peroxydases orales appartiennent aux mécanismes salivaires de défense innée non immunitaires qui contrôlent la flore microbienne orale. En présence de peroxyde d’hydrogène (H2O2), elles catalysent in vivo l’oxydation du thiocyanate (SCN-) en hypothiocyanite (OSCN-) et in vitro l’oxydation d’iodure (I-) en hypoiodite (OI-). Dans le compartiment salivaire et dans les biofilms oraux, l’H2O2 provient essentiellement des bactéries. Dans nos investigations, l’H2O2 était produit par une séquence enzymatique glucose (G) / glucose-oxydase (GOD). L’OSCN- et l’OI- sont des oxydants antibactériens, antiviraux et antifongiques. Peu d’études envisagent leur action sur les biofilms à Candida.<p>\ / Doctorat en Sciences dentaires / info:eu-repo/semantics/nonPublished

A great deal of evidence suggests that parental communication and involvement are essential for the development of language in young children. However, hearing parents of deaf children face unique challenges in providing appropriate stimulation and language input to their deaf children. To date, few studies have determined which types of input are best. This study utilized data collected from the largest, youngest, nationally representative sample of deaf children receiving cochlear implants. The purpose of this study was to identify the facilitative language techniques that are most effective in facilitating receptive and expressive language development in young deaf children. Ninety-three deaf children, ages 2 years and under were enrolled at six implant centers. Deaf children were assessed prior to implantation and then followed for three years post-implantation. At each assessment, parent-child interactions were videotaped in an unstructured Free Play and structured Art Gallery task. All parent and child speech, vocalizations, and sign language were transcribed from the 10 minute videotaped parent-child interactions and coded using the Parenting Strategies for Communication coding system. Results revealed that the most frequently used lower-level strategies used by parents were directives, comments, and close-ended questions. The most frequently used higher-level strategies were parallel talk, open-ended questions, and recast. In addition, the Art Gallery task facilitated more parent utterances and longer mean length of utterances compared to Free Play, but the frequency of facilitative language techniques was not different. Using bivariate latent difference score modeling, higher-level strategies predicted growth in expressive language scores across three years post-implantation. Further, higher-level strategies had a delayed effect on receptive language, with techniques used at 24 months post-implantation predicting growth in receptive language at 36 months post-implantation. These results suggested that parent's play an active role in facilitating their child's language development. Interventions for parents should be developed using a coaching model, where parents receive hands-on training and practice using these effective facilitative language techniques. Future studies should evaluate the effectiveness of this intervention, as well as the effectives of these language techniques in children implanted after 2 years of age.

Thesis (Ph. D.)--Massachusetts Institute of Technology, Dept. of Metallurgy and Material Science, 1974. / MICROFICHE COPY AVAILABLE IN ARCHIVES AND SCIENCE. / Vita. Bibliography: leaves 56-59. / by Thomas Maurice Devine, Jr. / Ph.D.