Many professionals have successfully implemented discrete trial teaching in the past. However, there have not been extensive studies examining the accuracy of discrete trial teaching implementation. This study investigated the use of Bug in Ear feedback on the accuracy of discrete trial teaching implementation among two pre-service teachers majoring in elementary education and one pre-service teacher majoring in exceptional education. An adult confederate was used to receive discrete trial teaching. Implementing a multiple baseline across participants design, this study examined whether there was a functional relationship between receiving Bug in Ear feedback and the accuracy of discrete trial teaching implementation. The discrete trial teaching evaluation form was utilized to measure the accuracy of discrete trial teaching implementation. The findings demonstrated an increase in the discrete trial teaching implementation accuracy after Bug in Ear feedback was introduced. Participants agreed that using a self-instruction manual combined with receiving Bug in Ear feedback was beneficial in learning to implement discrete trial teaching

A novel hybrid pulse-width modulation (PWM) update method is proposed to eliminate the effect of the one-step control time delay Td one without losing the full duty cycle range. Without the Td one to cause linear phase shifts that limit the control bandwidth and affect closed-loop stability, a very high quality digital current control can be achieved, such as a high closed current loop bandwidth, strong robustness against disturbances, ability to reach a very high fundamental frequency compared to switching frequency, etc. In a conventional digital control implementation, a sampling period (Tsamp) is allocated for the execution of samplings and computations, and the update of PWM outputs is delayed until the beginning of the following sampling period. This delayed PWM update method is the cause of the Td one. Instead of the delayed PWM update, if the PWM outputs are updated immediately after algorithm computations, then the effect of the Td one can be eliminated; however, the computation time delay Td comp from the current sampling instant through algorithm computations to the PWM update instant causes a reduced duty cycle range. Each of these two conventional PWM update methods has some shortcomings. A hybrid PWM update method is proposed to circumvent the aforementioned shortcomings and to incorporate only the advantages. The proposed method improves the performance by updating the PWM outputs multiple times during a Tsamp, whereas the PWM outputs are updated only one time during a Tsamp in the conventional methods. In spite of the simplicity of the proposed method, the performance improvements in stability, robustness and response characteristics are significant. On the other hand, the proposed method can be easily applied to many PWM based digital controls because of its simplicity. Additional to the hybrid PWM update method, a hybrid control method is proposed to optimize the sequence of control operations. It maximizes the current loops' robustness and minimizes the delay from the sampling of outer control loops' variables, such as voltage and speed, to the duty cycle update instant. The minimum delay enables the maximization of the outer control loops' bandwidth. Additionally, a corrective neutral offset voltage injection method is proposed to correct small PWM output deviations that may occur with the hybrid PWM update method. Utilizing a three-phase voltage source inverter with a permanent magnet synchronous machine as the platform, a deadbeat current control and a high speed ac drive experiments have been conducted to demonstrate the feasibility and validity. Notable results include a closed current loop response of one Tsamp with the deadbeat control and a 500 Hz current fundamental frequency with 1 kHz switching frequency in the high speed ac drive. / Ph. D.

Introduktion: Omedelbart kejsarsnitt är ett akut kirurgiskt ingrepp som utförs när det finns medicinska komplikationer som kräver omgående intervention för att skydda modern eller barnets liv. Proceduren utförs under tidspress och nästan alltid med generell anestesi, vilket innebär att de preoperativa förberedelserna ofta är begränsade. Anestesisjuksköterskans roll är avgörande i dessa situationer för att säkerställa en effektiv hantering av ingreppet. Stressfaktorer för anestesisjuksköterskor är påtagliga i dessa akuta situationer där snabba och korrekta beslut måste fattas under press. Metod: En kvalitativ intervjustudie har utförts med induktivt förhållningssätt för att beskriva anestesisjuksköterskors erfarenhet av omedelbart kejsarsnitt. Data analyserades med hjälp av en kvalitativ innehållsanalys. Resultat: Anestesisjuksköterskors erfarenheter vid omedelbart kejsarsnitt kan delas in i fyra kategorier: att känna stress och adrenalinpåslag när larmet går, att samarbeta under operation, att hantera stressmoment, och att arbeta strukturerat och vara förberedd. Diskussion: Studien betonar behovet av tydlig kommunikation och samarbete för att minska stress och förbättra resultatet vid omedelbara kejsarsnitt. Simuleringsövningar och kompetensbaserad utbildning är centrala för att stärka beredskapen hos anestesisjuksköterskan. Slutligen kan personlighetsdrag och emotionell intelligens påverka hur anestesisjuksköterskor hanterar stressiga situationer som vid omedelbart kejsarsnitt. Slutsats: Anestesisjuksköterskor var i aktuell studie väl förberedda och kapabla att hantera omedelbara kejsarsnitt tack vare kunskap och kommunikation, tydliga rutiner och standardisering, erfarenhet och personliga egenskaper. Det visar att förberedelse, kompetens, rutiner och samarbete är avgörande för hantering av dessa akuta situationer. Ytterligare forskning behövs för att optimera hanteringen genom träningsprogram samt förbättra kommunikation och rutiner för att öka anestesisjuksköterskans beredskap inför omedelbart kejsarsnitt.

in english The Master's thesis deals with burnout syndrome which is a frequently discussed topic in helping professions. Specifically, the syndrome is being inspected in workers of facilities for children requiring immediate help. In the theoretical part, the interpretation of the term burnout syndrome, its symptoms and preventive measures are defined. The practical part conducts a survey (with use of questionnaire)of situation in which the workers of facilities for children requiring immediate help in connection with the burnout syndrome are. Likewise, some leading workers of these facilities are given the floor in form of interviews to clarify which preventive measures they choose in order to avoid the burnout syndrome in their workers.

Summaries in Afrikaans and English / Text in Afrikaans / In hierdie ondersoek is daar navorsing gedoen oor die aard en rol van fisiese beheer in die sakereg met die oog daarop om dit te omskryf en die funksies daarvan te identifiseer. By die verkryging van eiendomsreg word net vereis dat die fisiese beheer wat ten aansien van die saak uitgeoefen word, effektief moet wees. Of 'n saak effektief beheer word al dan nie, word aan die hand van die heersende verkeersopvattings getoets. Hierdie verkeersmaatstawwe wat in die praktyk ten aansien van bepaalde soorte sake uitgekristalliseer het, is buigsaam en veranderlik en dit maak dit moontlik dat die reg by maatskaplike en ekonomiese veranderinge aanpas. Die funksie van fisiese beheer in gevalle van verkryging is altyd publisiteit. In die geval van die beskerming van eiendomsreg word fisiese beheer besonder breed omskryf en daar word slegs verwag dat die persoon van wie die saak teruggeeis word, genoegsame beheer daaroor moet he om dit te kan teruggee. Die funksie van beheer is hier suiwer funksioneel. By die verlies van eiendomsreg speel fisiese beheer nie juis 'n besondere rol nie aangesien die verlies van beheer nie noodwendig op die verlies of beeindiging van eiendomsreg dui nie. Wanneer dit wel ter sprake kom, is die funksie daarvan publisiteit. In die geval van die verkryging van besit en houerskap, dien daarop gelet te word dat die enigste vereiste is dat beheer effektief moet wees en dit word weer eens aan die hand van verkeersmaatstawwe bepaal. Fisiese beheer word strenger omskryf vir verkryging as vir behoud. By die beskerming van besit en houerskap is die enigste vereiste wat gestel word dat beheer vreedsaam en ongestoord moes gewees het. Wanneer beheer oor 'n saak verloor word, gaan dit gewoonlik gepaard met die verlies van besit of houerskap. Die funksie van fisiese beheer is deurgaans publisiteit. Fisiese beheer word redelik streng omskryf vir doeleindes van 'n gewone pand en daar word gewoonlik vereis dat die pandsaak gelewer en gehou moet word vir die vestiging en behoud van 'n pandreg. Die funksies van beheer is hier sekuriteit en publisiteit. / This study examines the nature and role of physical control in the law of property with a view to defining this concept and identifying its functions. The only requirement for the acquisition of ownership is the exercise of effective physical control of the thing in question. Whether or not a thing is physically under control, is determined by the application of legal indicators deriving from use and custom. Such indicators as have cristallised in practice in respect of certain classes of things, are flexible and variable and enable the law to adjust to social and economical changes. The function of physical control in cases of acquisition is always publicity. The definition of physical control in cases of protection of ownership is particularly wide, the only requirement being that the person from whom the thing is reclaimed must have sufficient physical control of it to enable him to return it. The function of control is purely functional. Since loss of control does not necessarily indicate the termination or loss of ownerhip, physical control has no significant part to play in respect of loss, of ownership. Where it does come into play, however, its function will be publicity. In cases of acquisition of possession and holdership it is essential that physical control of the thing is effective and once again this will be determined by application of legal indicators. The definition of physical control is much narrower in respect of acquisition than in respect of retention. The only requisite for the protection of possession and holdership is peaceful and undisturbed physical control. Loss of control of a thing is usually indicative of loss of possession or holdership. Throughout the function of control is publicity. Physical control is quite narrowly defined in cases of ordinary pledge insofar as delivery and retention of the pledge object are usually required for the establishment and continuation of the pledge. In this instance, physical control serves the functions of both publicity and security. / Mercantile Law / LL.D.

Esta pesquisa teve como objetivos, avaliar a influência da técnica de Calatonia sobre as condições clínicas (pressão arterial sistêmica, frequências cardíaca e respiratória, temperatura corpórea axilar, saturação de oxigênio), dor e índices de Aldrete e Kroulik e de Ramsay, dos pacientes no período pós-operatório imediato. Foi realizado um estudo randomizado, com cento e dezesseis pacientes, submetidos à cirurgia de colecistectomia por videolaparoscopia, divididos em grupos experimental (58 pacientes) e placebo (58 pacientes). Os pacientes do grupo experimental receberam a técnica da Calatonia, e os do placebo foram submetidos apenas a toques não intencionais. Os resultados mostraram que os pacientes dos grupos placebo e experimental foram considerados homogêneos quanto às variáveis: sexo, idade, ASA (Physical Status Classification), tempo de procedimento cirúrgico e de permanência na Sala de Recuperação Pós-Anestésica (SRPA). Não se observaram diferenças estatisticamente significantes, entre os grupos, quanto à avaliação clínica da escala de Aldrete e Kroulik e escala de sedação de Ramsay e aos parâmetros clínicos, com exceção da temperatura corpórea axilar, que apresentou diferença estatística significante, no momento de admissão na SRPA. Quanto à dor os pacientes do grupo experimental, apresentaram resultados significativos, podendo-se inferir que o relaxamento proporcionado pela técnica de Calatonia trouxe o alívio do quadro doloroso e, sendo assim, pode-se considerá-la como uma terapia adjuvante para o alívio da dor. Conclui-se que a aplicação da Calatonia pode atuar como recurso complementar à assistência no período pós-operatório imediato, priorizando a subjetividade do ser humano, sem se distanciar da realidade da instituição. Por se tratar de uma proposta inovadora, com a aplicação da técnica no período pós-operatório imediato, acredita-se que a Calatonia contribuirá para uma melhora do quadro clínico, proporcionando o bem-estar físico e emocional do paciente, além de resgatar a assistência humanizada e individualizada. / This research had as objective to evaluate the influence of the technique of Calatonia on the clinical conditions (systemic arterial pressure, cardiac and respiratory frequencies, axillary corporal temperature, oxygen saturation), pain and indexes of Aldrete and Kroulik and that of Ramsay, of the patients in the immediate postoperative period; A randomized study was carried through, with one hundred and sixteen patients, submitted to the Videolaparoscopic cholecystectomy surgery, divided in groups: experimental (58 patients) and placebo (58 patients). The patients of the experimental group received the Calatonia technique, and those of placebo group were submitted only to non-intentional touchs. The results showed that the patients of the groups placebo and experimental were considered homogeneous in which refers to the variables: sex, age, ASA (Physical Status Classification), in the Postanaesthetic Recovery Room (SRPA) it was not observed any significant statistical differences, between the groups, as to the clinical evaluation of the Aldrete and Kroulik scale as well as the sedation scale of Ramsay and the clinical parameters, except the axillary corporal temperature, which presented significant statistical difference, at the moment of the admission at the SRPA. As to the pain, the patients of the experimental group presented significant results, being it possible to infer that the relaxation proportionated by the technique of Calatonia brought the relief of the painful status and, thus, it can be considered as an adjuvant therapy for the relief of the pain. So, it can be concluded that the application of the Calatonia can act as complementary resource to the assistance in the immediate postoperative period, prioritizing the subjectivity of the human being, without leaving the reality of the institution. Since it is a innovative proposal, with the application of the technique in the immediate postoperative period, it is given credit that the Calatonia will contribute for an improvement of the clinical situation, providing the physical and emotional patient well-being, besides rescuing the human and individualized assistance as well.

A reabsorção óssea alveolar associada as perdas dentais constitui uma condição inerente ao processo de cicatrização fisiológico natural. Técnicas como a instalação de implantes imediatos e técnicas de preservação alveolar têm sido sugeridas com o objetivo de limitar as alterações adversas sofridas pelo processo alveolar. Contudo, frequentemente as perdas dentárias estão associadas a infecções crônicas que tradicionalmente contraindicariam os procedimentos de enxerto ou implantes imediatos, a menos que meticulosos debridamento e irrigação alveolar associados a adequado protocolo antibiótico pré e pós-operatório sejam empregados. Alternativas precisam ser testadas para a substituição do uso indiscriminado de antibioticoterapia sistêmica. O objetivo do presente estudo foi avaliar o efeito da TFDa na descontaminação de alvéolos infectados previamente a instalação de implantes imediatos e na cicatrização de alvéolos pós-extração associados ou não ao uso de enxertos xenógeno através de análises microtomográficas e histomorfométricas. Para tanto, foram selecionados 8 cães, os quais foram submetidos a uma fase de indução de doença periodontal por ligadura, seguida por um período de estabelecimento da doença. Após a exodontia dos prémolares bilaterais, aleatoriamente os alvéolos de um lado da mandíbula foram descontaminados por debridamento mecânico associado a irrigação com solução salina (grupo controle) e do outro lado por debridamento mecânico e irrigação com solução salina associados a terapia fotodinâmica antimicrobiana (grupo teste), e subsequentemente submetidos a instalação de implantes imediatos, dando origem aos grupos GT-I (Grupo Teste - Implante) e GC-I (Grupo Controle - Implante). Os demais alvéolos, foram utilizados para o estudo da dinâmica de cicatrização alveolar. Os sítios foram aleatoriamente alocados em: GT-C (Grupo teste - Coágulo), GT-BO (Grupo Teste - Bio-Oss®), GT-BOC (Grupo Teste - Bio-Oss® Collagen), GC-C (Grupo Controle - Coágulo), GC-BO (Grupo Controle - Bio-Oss®) e GC-BOC (Grupo Controle - Bio-Oss® Collagen). Após 12 semanas, os cães foram sacrificados e as amostras processadas para as análises de microtomografia computadorizada, histologia e histomorfometria. Na avaliação da cicatrização dos alvéolos pós-extração, embora os alvéolos descontaminados com TFDa (GT-C, GT-BO, GT-BOC) tenham apresentado melhores resultados numéricos, em relação a altura da crista óssea vestibular (ACOV) e a dimensão buco-lingual (DBL), não foram evidenciadas diferenças relevantes na análise histomorfométrica. Apenas a ACOV, mensurada na avaliação microtomográfica bidimensional, demonstrou-se significativamente inferior nos alvéolos do grupo teste que não receberam material de enxerto (GT-C) quando comparados aos respectivos alvéolos do grupo controle (GC-C). Na avaliação dos implantes imediatos, a análise histomorfométrica dos parâmetros: reabsorção da crista óssea vestibular (RCOV) e contato osso implante (BIC) demonstrou resultados significantemente superiores no GT-I em relação ao GC-I, e do parâmetro densidade óssea (DO) demonstrou apenas resultado numericamente superior no GT-I em relação ao GC-I. Todas as análises microtomográficas bidimensionais (RCOV) e tridimensionais (volume ósseo BV, porcentagem óssea BV/TV, densidade de superfície óssea BS/TV, espessura trabecular Tb.TH, número de trabéculas Tb.N e separação trabecular Tb.SP) demonstraram resultados significantemente melhores nos implantes do grupo teste (GT-I) em relação aos implantes do grupo controle (GC-I). A TFDa demonstrou potencial como agente de descontaminação de alvéolos pósextração periodontalmente infectados, previamente a instalação de implantes imediatos e na cicatrização de alvéolos pós-extração associados ou não a materiais de enxerto xenógenos, sem o uso de antibioticoterapia sistêmica associada. / Alveolar bone resorption following tooth loss is an inherent condition of the natural healing process. Therefore, several techniques, such as immediate implants placement and post extraction socket preservation, have been suggested in order to limit the adverse changes suffered by the alveolar process. However, extraction sockets commonly results from the removal of teeth affected by chronic infection, which conventionally contraindicates immediate bone graft and implant placement unless meticulous wound debridement and alveolar irrigation associated to a suitable pre- and post-operatory antibiotic protocol are employed. Alternatives ought to be tested in order to substitute the indiscriminate use of systemic antibiotic therapy. The aim of the present study was to evaluate the effect of the antimicrobial photodynamic therapy (aPDT) in the decontamination of infected post extraction sockets, previously to immediate implant placement and in the healing of post extraction sockets associated or not to xenografts. In the first phase, periodontitis was induced with ligatures in the mandibular premolars of eight beagle dogs. After 2 months, in the second phase of the study the dogs had their mandibular bicuspids bilaterally extracted, and randomly one hemi-mandible was decontaminated by mechanic debridement associated to saline solution irrigation (Control Group - CG), and the other hemi-mandible was decontaminated with mechanic debridement and saline solution irrigation associated to antimicrobial photodynamic therapy (Test Group - TG). Thereafter, 3 immediate implants in each side of the mandible were placed and the following groups were devised: TG-I (Test Group - Implant) and CG-I (Control Group - Implant). The remaining sockets were used for the study of the healing dynamic. The sockets were randomly assigned to the following groups: Test Group - Blood clot (TG-BC), Test Group Bio- Oss® (TG-BO), TG - BOC (Test Group Bio-Oss® Collagen), Control Group - Blood Clot (CG-BC), Control Group - Bio-Oss® (CG-BO) and Control Group - Bio-Oss® Collagen (CG-BOC). After 12 weeks, the dogs were sacrificed and the specimens were processed for microtomographic, histological and histomorphometric analysis. When the post extraction healing process was evaluated, the aPDT decontaminated sockets (TG-BC, TG-BO and TG-BOC) presented better numerical results in comparison to both buccal bone crest height (BCL) and in the bucco-lingual dimension (BLD). However, there were no statistically differences among the groups for these parameters in the histomorphometric analysis. Only the BCL measured in the two-dimensional microtomographic analysis showed statistic better results in the TG-BC when compared to the CG-BC. In the evaluation of the immediate implant placement the histomorphometric analysis presented statistically better results for the TG-I in the bone-implant contact (BIC), as well as in the vertical buccal bone loss (VBBL). The bone density (BD) was numerically better in the TG-I than in the CG-I. Both two-dimensional (VBBL) and three-dimensional (bone volume BV, percentage of the total bone volume - BV/TV, bone surface density - BS/TV, trabecular thickness Tb.Th, trabecular separation Tb.Sp and trabecular number TB.N) microtomographic analysis showed statistically better results in the TG-I. The aPDT showed potential in the decontamination of infected post extraction sockets previously to immediate implant placement and in the healing of post extraction sockets associated or not to xenogeneic grafts, without the use of systemic antibiotics.

Les réactions d'hypersensibilité immédiate survenant au cours de l'anesthésie demeurent un sujet de préoccupation majeure pour les anesthésistes. Le médicament le plus fréquemment responsable d'une anaphylaxie sont les curares. Le but de ce travail est de préciser l'épidémiologie actuelle et d'identifier certains facteurs environnementaux susceptibles d'expliquer la fréquence élevée des réactions allergiques aux curares qui peuvent survenir en l'absence de toute exposition préalable. Dans la première partie de la thèse, une enquête nationale décrivant l'épidémiologie des réactions anaphylactiques peranesthésiques entre 2005 et 2007 en France. Elle a confirmé l'intérêt du dosage d'IgE spécifique anti-curare. La survenue de réactions d'hypersensibilité immédiate allergique à l'induction anesthésique lors d'une première exposition aux curares a conduit à évoquer l'existence d'une sensibilisation croisée avec des substances présentes dans l'environnement et possédant un ammonium quaternaire. Différentes hypothèses ont été proposées, notamment une exposition aux produits cosmétiques et/ou désinfectants, une exposition à des antigènes de type phosphorylcholine rencontrés dans les levures, ou certains parasites. Dans la deuxième partie de la thèse, deux populations professionnelles, des apprentis coiffeurs exposés à des agents chimiques contenant des ions ammoniums, et des boulanger-pâtissiers exposés à des allergènes de levures et de parasites, ont été comparées avec la population générale à la recherche de différences concernant la prévalence des anticorps IgE spécifique anti-curare. Au terme de ce travail, l'exposition à des produits cosmétiques chez les coiffeurs apparaît comme un facteur de risque de développer des anticorps IgE spécifique anti-curare, démontrant pour la première fois l'hypothèse du lien entre l'exposition répétée aux produits cosmétiques contenant l'ammonium quaternaire et la sensibilisation croisée aux curares / Immediate hypersensitivity reactions occurring during anesthesia remains a major concern for anesthesiologists. The drugs most frequently responsible for anaphylaxis are neuromuscular blocking agents (NMBAs). The purpose of this study is to determine the current epidemiology and to identify environmental factors that may explain the high frequency of allergic reactions to neuromuscular blocking agents that can occur without any prior exposure. In the first part of the thesis, a national survey describing the epidemiology of anaphylaxis during anesthesia between 2005 and 2007 in France was carried out. The value of testing specific IgE against NMBA was confirmed.The occurrence of immediate allergic hypersensitivity reaction when first exposure to an NMBA during induction led to evoke the existence of cross-sensitization with substances present in environment and having a quaternary ammonium compound. Different hypotheses have been proposed including exposure to cosmetics and / or disinfectants, exposure to antigens encountered in phosphorylcholine yeasts, or parasites, or exposure to a derivative opiate, pholcodine. In the second part of the thesis, two occupational populations, hairdressers apprentice exposed to chemical agents containing ammonium ions, baker and pastry maker exposed to allergens yeast and parasites were compared with the general population to search for differences regarding the prevalence of specific IgE antibody against NMBA. At the end of this work, hairdressers exposed to cosmetics agents appears to be a risk factor for developing specific IgE antibodies against NMBA and we demonstrated for the first time the hypothesis of the ross-sensitization between repeated exposures to cosmetics products containing quaternary ammonium and NMBAs

Avaliou-se o comportamento biomecânico, quanto à área de estabilidade protética, extensão de cantilever e estabilidade por análise freqüência de ressonância (AFR); parâmetros clínicos: índice de placa (IP), índice de sangramento (IS), supuração, distância da plataforma do implante-margem da mucosa (DPM), profundidade de sondagem (PS), nível de inserção (NI), sangramento à sondagem (SS), largura (LM), espessura (EM) da mucosa e análise radiográfica, em dois sistemas de reabilitações implanto-suportadas. Foram instalados 104 implantes, submetidos à ativação imediata, em 26 pacientes, divididos em dois grupos: A (n= 16, All-on-4®-Nobel Biocare) e B (n=10, Neopronto®-Neodent). As próteses foram instaladas em tempo médio de 32h. (T0), e controles realizados em seis (T6), doze (T12) e 24 meses (T24). Como resultado, a taxa de sucesso foi de 100% para o grupo A e 90% para o grupo B para implantes e próteses. Diferenças significantes (p<0,05) foram apresentadas entre o cantilever posterior 10,96mm e 18,81mm e o braço de resistência (BR) 13,87mm e 5,50mm, respectivamente para os grupos A e B. A área de estabilidade, no grupo A foi de 373,5mm2 e no B de 112,8mm2; a média da AFR (em ISQ) do grupo A T0= 68,62; T6=64,40; T12=67,07; T24=66,53 e do grupo B T0= 68,37; T6=66,29; T12=67,09; T24=67,10, com diferenças (p<0,05) entre os tempos (grupo A) e posição dos implantes (grupo B). O IP no grupo A=1,0 e 0,7; grupo B=0,6 e 0,9, o IS (0,7), supuração (ausente) e SS (presença) no grupo A=50% e 37,9%; grupo B=70,1 e 52,1%, no controle de 12 e 24 meses, não mostraram diferenças estatísticas entre os grupos. As médias (em mm) da LM para o grupo A (2,05 e 2,21) e B (2,29 e 2,40) e EM grupo A (1,53 e 1,56) e B (1,31 e 1,43), DPM do grupo A (2,54e 2,52) e B (0,18mm e -0,12mm), PS grupo A (3,52 e 3,52) e B (3,52 e 4,0), NI grupo A (0,98 e 0,99) e B (3,05 e 3,57) e perda óssea grupo A (0,45mm e 0,23mm ) grupo B(0,66mm e 0,22mm), respectivamente para 12 e 24 meses, apresentaram diferenças estatísticas entre os controles. Concluindo-se que 1- O grupo A apresentou área de estabilidade e extensão de cantilever anterior e posterior, com comportamento biomecânico mais favorável do que no grupo B; 2- A estabilidade primária e secundária (AFR) foi diferente entre os tempos (grupo A) e posição dos implantes (grupo B), mas semelhantes entre os grupos; 3- Os parâmetros clínicos de índice de placa, sangramento marginal, supuração, profundidade de sondagem (exceto para os períodos de controle no grupo B), sangramento a sondagem, largura e espessura de mucosa ceratinizada foram semelhantes entre os grupos; 4- A distância da plataforma do implante-margem da mucosa foi maior no grupo A e o nível de inserção foi maior no grupo B; 5- A perda na altura da crista óssea foi semelhante entre os grupos; 6- A perda óssea foi menor nos implantes anteriores do que nos posteriores, nos grupos. / Two implant-supported rehabilitation systems were evaluated considering their biomechanical behavior, the area of prosthetic stability, cantilever extensions, stability using resonance frequency analysis (RFA) and clinical parameters, such as: modified plaque index (PI), modified bleeding index (BI), suppuration, distance between the implant shoulder and the mucosal margin (DIM), probing pocket depth (PD), probing attachment level (PAL), bleeding on probing (BP), thickness (TM) width (WM) of keratinized mucosa and radiographic analysis. One hundred and four implants had been installed in twenty six patients, submitted to immediate loading and divided into two groups: A (n=16, All-on-4®-Nobel Biocare) e B (n=10, Neopronto®-Neodent). The prosthesis had been installed in average time of 32h (T0), and controls made in (T6), 12 (T12) and 24 months (T24). As result, the success rate was 100% for the group A and 90% for the group B for both implants and prosthesis. Significant differences (p<0,05) 10,96mm and 18,81mm had been presented between posterior cantilever and the resistance arm (RA) 13,87mm and 5,50mm, respectively for the groups A and B. The stability area, in the group A was of 373,5mm2 and in B of 112,8mm2; the average of RFA (in ISQ) of the group A T0= 68,62; T6=64,40; T12=67,07; T24=66,53 and of the group B T0= 68,37; T6=66,29; T12=67,09; T24=67,10, with differences (p<0,05) between the periods (Group A) and implant position (Group B). The PI in group A was of 1,0 and 0,7 and 0,6 and 0,9 for group B, o BI (0,7), suppuration (absent), DP (presence) in group A=50% and 37,9%; group B=70,1 and 52,1%, in the control of 12 and 24 months, did not present statistical differences between the groups. The average (in mm) of WM for the group A (2,05 and 2,21) and B (2,29 and 2,40) and TM group A (1,53 and 1,56) and B (1,31 and 1,43), DIM of group A (2,54 and 2,52) and B (0,18mm and -0,12mm), DP group.

A proposta neste estudo foi avaliar as alterações da densidade ótica do osso alveolar perimplantar cervical em controle longitudinal, por meio de radiografias periapicais digitalizadas de dez pacientes, nos quais foram instalados seis implantes na maxila submetidos à função oclusal imediata, mediante a instalação de uma prótese fixa 24 horas após a cirurgia. Todos os pacientes foram avaliados clinicamente, com exames da análise da freqüência de ressonância, além de controle radiográfico. Foi utilizada a técnica radiográfica intrabucal do parale lismo, com cone longo, sendo que o feixe de raios X incidiu perpendicularmente ao longo eixo do implante. Os controles radiográficos foram realizados na instalação da prótese, após 6 meses e após 12 meses. As radiografias obtidas foram então capturadas por uma câmera de vídeo (preto e branco) por meio de um microscópio ótico (40 vezes de aumento). Devido à ampliação utilizada, os implantes tiveram suas imagens digitalizadas em 2 etapas (metade direita e metade esquerda), sendo consideradas como amostras independentes. Após a sobreposição de um gabarito sobre a imagem, com a finalidade padronizar as áreas a serem estudadas, foram analisadas as densidades óticas na área de interesse osso + implante e na área de controle implante (onde não é esperada alteração) por meio do software ImageLab. Para a correção de possíveis variações na densidade da radiografia e projeção geométrica oriundas da metodologia empregada, foi utilizada uma equação matemática para validar a análise dos dados obtidos. Os resultados mostraram que ocorreu variação percentual da densidade ótica na área de interesse (osso + implante) nos primeiros seis meses (T2) com diminuição de aproximadamente 5% para o lado direito e diminuição de aproximadamente 6% para o lado esquerdo em relação às radiografias iniciais (T1) e após doze meses, a diminuição da densidade ótica estabilizou-se, não sendo encontradas alterações estatisticamente significantes em relação ao período correspondente entre T2 (seis meses) e T3 (doze meses). Os resultados da análise digital das radiografias periapicais demonstraram coincidência com os resultados da análise da freqüência de ressonância e exame clínico dos implantes e demonstraram um aspecto compatível com o sucesso dos implantes osteointegrados com função imediata na maxila. / The aim in this study was the evaluation of the variations of the perimplantar optical bone density at the cervical region in a longitudinal control, by the use of digitized radiographs of ten patients, who received six implants installed in the maxilla and submitted to immediate occlusion function, through fixed prosthesis installed 24 hours after the surgery. All the patients were observed in clinical control, with resonance frequency analysis and also radiographic control. It was performed a intraoral radiograph using the paralleling technique, with the long cone and the beam of x-ray aimed perpendicular to the long axis of the implant. The radiographic controls were done at the time of the installation of the prosthesis, after six months and after twelve months after the first control. The obtained radiographs were captured by a black and white video camera by an optical microscope (40 times of magnification). Due to the utilized magnification, the implants have their images digitized in two steps: half right and half left, and they were considered as independent samples. After the superimposition of a standardized pattern, to help the standardization of the areas of the study, it was analyzed the optical density at the areas of interest bone + implant and at areas of control bone (where it is not hope changes) through the software ImageLab. To correct possible variations of the effect of the absence of standardization of the geometric projection and the radiographic density, it was realized a mathematic equation and it was obtained a correction factor of density in order to compensate. The results sho wed that there were percentage variation of the optical density at the area of interest (bone + implant) at six months (T2) showed a decreased of about 5% for the right side and showed a decreased of about 6% for the left side when analyzed the first control and after twelve months no significant statistical difference was observed between the T2 period (six months) and T3 period (twelve months). The results of digital analysis from the intraoral radiographs showed as the same as the results of resonance frequency analysis and the clinic examination of the implants and showed a success of implants installed in the maxilla with immediate occlusion function.