A osteonecrose dos maxilares associada ao uso dos Bisfosfonatos é uma exposição óssea que persiste por mais de 8 semanas na cavidade oral em pacientes sob tratamento com bisfosfonatos e que não foram submetidos a radioterapia de cabeça e pescoço. Explicar o motivo do desenvolvimento destas lesões ósseas principalmente nos maxilares e desvendar a sua patofisiologia ainda é necessário. Por isso, o reparo ósseo em um modelo animal de osteonecrose dos maxilares associada ao uso de bisfosfonatos em ratos Wistar (Rattus norvegicus, albinus) foi avaliado através de análise microscópica e molecular. A amostra foi composta por 48 ratos machos, com 12 semanas de vida e peso aproximado de 300 gramas, que foram submetidos a administração de Ácido Zoledrônico, 0,6 mg/kg a cada 28 dias com um total de 5 doses. Os animais foram dividos em quatro grupos, cada um composto por 12 animais; 2 grupos de tratamento AZ e AZ-experimental (AZ-exp) e 2 grupos controles CO e CO-experimental (CO-exp) com administração de cloreto de sódio 0,9% no mesmo volume e frequencia do Ácido Zoledrônico. As soluções foram administradas por via intraperitoneal. O grupo AZ-exp e o CO-exp foram submetidos a exodontias dos molares superiores direitos e a realização de defeito ósseo no fêmur esquerdo 45 dias após a primeira aplicação das soluções. A eutanásia dos animais ocorreu após 150 dias do início do experimento. A avaliação histológica foi realizada através de análises qualitativa e quantitativa, verificou a presença de sequestros ósseos, áreas de osteonecrose e áreas de osso total por meio de estudos de microscopia óptica pela coloração Hematoxilina e Eosina. Análise quantitativa da expressão do RNAm de proteínas envolvidas no processo de reparo ósseo pelo método de reação em cadeia da polimerase em tempo real (RealTimePCR) também foi realizada para avaliação dos osteoclastos (RANK, RANKL e OPG), osteoblastos (ALPL e OCN) osteócitos (DMP-1 e PHEX) e vascularização (VEGF). Apenas o grupo com administração de AZ e realização de exodontias apresentou sequestros ósseos e áreas significativamente maiores de osteonecrose em comparação aos animais com exodontia e sem a administração de AZ. Não foram encontradas áreas de osteonecrose na análise do fêmur. A avaliação do osso total apresentou maior quantidade de osso nos animais submetidos a procedimentos cirúrgicos e administração de AZ, porém não houve significância estatística. Na análise molecular, a administração de AZ e a realização das exodontias e do defeito ósseo, provocou alteração na expressão de marcadores para osteoclastos. A administração do AZ associada à realização dos procedimentos cirúrgicos aumentou a expressão de marcadores iniciais da osteoblastogênese e diminuiu a expressão tardia dos osteoblastos. A expressão de marcadores de osteócitos foi menor após a administração de AZ e exodontias na maxila, no entanto, no fêmur, houve aumento na expressão destes marcadores. A realização das exodontias e de defeitos ósseos no fêmur aumentou a expressão de VEGF nos grupos com e sem administração de AZ. Estes resultados evidenciam a interferência do Ácido Zoledrônico no reparo ósseo dos alvéolos e dos defeitos ósseos nos fêmures, causando incidência de osteonecrose na maxila, atraso na remodelação óssea, e ausência de lesões de osteonecrose no fêmur. A presença de lesões de osteonecrose na maxila pode ser consequência do atraso na remodelação óssea, evidenciado pela alteração na expressão de marcadores para osteclastos e osteoblastos, e as mesmas ocasionam a diminuição da expressão de proteínas pelos osteócitos. / Bisphosphonate-related osteonecrosis of the jaws is a bone exposure persisting for more than 8 weeks in the oral cavity in patients receiving bisphosphonates and who did not undergo radiation therapy for head and neck. Explain the reason for these development bone lesions mainly in the jaws and unveil its pathophysiology is still needed. Therefore, the bone repair in an animal model of Bisphosphonate-related osteonecrosis of the jaws in Wistar rats (Rattus norvegicus, Albinus) was evaluated by microscopic and molecular analysis. The sample was composed of 48 male rats, with 12 weeks old and weighing approximately of 300 grams, who underwent the administration of zoledronic acid, 0.6 mg / kg every 28 days with a total of 5 doses. The animals were divided into four groups, each consisting of 12 animals; 2 treatment groups AZ and AZ-experimental (AZ-exp) and 2 control groups CO and CO-experimental (CO-exp) with sodium chloride administration 0.9% in the same volume and frequency of zoledronic acid. All solutions were administered intraperitoneally. The AZ-exp group and the CO-exp group underwent extractions rights upper molars and the bone defect was performed in the left femur 45 days after the first application of the solutions. Euthanasia of animals occurred after 150 days from the beginning of the experiment. Histological evaluation was performed through quantitative and qualitative analysis checked the presence of bone sequestration, osteonecrosis area and whole bone areas by means of optical microscopy by hematoxylin-eosin staining. Quantitative analysis of mRNA expression of proteins involved in bone repair by polymerase chain reaction method in real time (RealTimePCR) was also performed: osteoclasts (RANK, RANKL and OPG), osteoblasts (ALPL and OCN) osteocytes (PMD-1 and PHEX) and vascularization (VEGF). Only the group with administration of AZ and performing tooth extractions presented bone sequestration and significantly larger areas of osteonecrosis when compared to animals with extraction and without AZ administration. There were no areas of osteonecrosis of the femoral analysis. The evaluation of the whole bone showed more bone in animals undergoing surgeries and AZ administration but there was no statistical significance. Molecular analysis, AZ administration and the performance of tooth extractions and bone defect changed the expression of markers for osteoclasts. The AZ administration associated with surgical procedures increased the expression of early markers of osteoblastogenesis and decreased the late expression of osteoblasts. The expression of osteocytes markers was lower after AZ administration and maxillary tooth extractions; however, there was an increase in the expression of these markers in the femur. The performance of tooth extractions and bone defects in the femur increased VEGF expression in animals with and without administration of AZ. These results show the interference of zoledronic acid on bone repair of the sockets and bone defects in the femurs, causing incidence of osteonecrosis of the upper jaw, delayed bone remodeling, and no femoral osteonecrosis injuries. The presence of osteonecrosis injuries in the upper jaw can be the consequence of the delay on bone remodeling, evidenced by the change in the markers expression for osteoclasts and osteoblasts, and they cause the decreased in protein expression by osteocytes.

Thesis (M.S.)--University of Michigan, 1989.

Thesis (M.S.)--University of Michigan, 1989.

A osteonecrose dos maxilares associada ao uso dos Bisfosfonatos é uma exposição óssea que persiste por mais de 8 semanas na cavidade oral em pacientes sob tratamento com bisfosfonatos e que não foram submetidos a radioterapia de cabeça e pescoço. Explicar o motivo do desenvolvimento destas lesões ósseas principalmente nos maxilares e desvendar a sua patofisiologia ainda é necessário. Por isso, o reparo ósseo em um modelo animal de osteonecrose dos maxilares associada ao uso de bisfosfonatos em ratos Wistar (Rattus norvegicus, albinus) foi avaliado através de análise microscópica e molecular. A amostra foi composta por 48 ratos machos, com 12 semanas de vida e peso aproximado de 300 gramas, que foram submetidos a administração de Ácido Zoledrônico, 0,6 mg/kg a cada 28 dias com um total de 5 doses. Os animais foram dividos em quatro grupos, cada um composto por 12 animais; 2 grupos de tratamento AZ e AZ-experimental (AZ-exp) e 2 grupos controles CO e CO-experimental (CO-exp) com administração de cloreto de sódio 0,9% no mesmo volume e frequencia do Ácido Zoledrônico. As soluções foram administradas por via intraperitoneal. O grupo AZ-exp e o CO-exp foram submetidos a exodontias dos molares superiores direitos e a realização de defeito ósseo no fêmur esquerdo 45 dias após a primeira aplicação das soluções. A eutanásia dos animais ocorreu após 150 dias do início do experimento. A avaliação histológica foi realizada através de análises qualitativa e quantitativa, verificou a presença de sequestros ósseos, áreas de osteonecrose e áreas de osso total por meio de estudos de microscopia óptica pela coloração Hematoxilina e Eosina. Análise quantitativa da expressão do RNAm de proteínas envolvidas no processo de reparo ósseo pelo método de reação em cadeia da polimerase em tempo real (RealTimePCR) também foi realizada para avaliação dos osteoclastos (RANK, RANKL e OPG), osteoblastos (ALPL e OCN) osteócitos (DMP-1 e PHEX) e vascularização (VEGF). Apenas o grupo com administração de AZ e realização de exodontias apresentou sequestros ósseos e áreas significativamente maiores de osteonecrose em comparação aos animais com exodontia e sem a administração de AZ. Não foram encontradas áreas de osteonecrose na análise do fêmur. A avaliação do osso total apresentou maior quantidade de osso nos animais submetidos a procedimentos cirúrgicos e administração de AZ, porém não houve significância estatística. Na análise molecular, a administração de AZ e a realização das exodontias e do defeito ósseo, provocou alteração na expressão de marcadores para osteoclastos. A administração do AZ associada à realização dos procedimentos cirúrgicos aumentou a expressão de marcadores iniciais da osteoblastogênese e diminuiu a expressão tardia dos osteoblastos. A expressão de marcadores de osteócitos foi menor após a administração de AZ e exodontias na maxila, no entanto, no fêmur, houve aumento na expressão destes marcadores. A realização das exodontias e de defeitos ósseos no fêmur aumentou a expressão de VEGF nos grupos com e sem administração de AZ. Estes resultados evidenciam a interferência do Ácido Zoledrônico no reparo ósseo dos alvéolos e dos defeitos ósseos nos fêmures, causando incidência de osteonecrose na maxila, atraso na remodelação óssea, e ausência de lesões de osteonecrose no fêmur. A presença de lesões de osteonecrose na maxila pode ser consequência do atraso na remodelação óssea, evidenciado pela alteração na expressão de marcadores para osteclastos e osteoblastos, e as mesmas ocasionam a diminuição da expressão de proteínas pelos osteócitos. / Bisphosphonate-related osteonecrosis of the jaws is a bone exposure persisting for more than 8 weeks in the oral cavity in patients receiving bisphosphonates and who did not undergo radiation therapy for head and neck. Explain the reason for these development bone lesions mainly in the jaws and unveil its pathophysiology is still needed. Therefore, the bone repair in an animal model of Bisphosphonate-related osteonecrosis of the jaws in Wistar rats (Rattus norvegicus, Albinus) was evaluated by microscopic and molecular analysis. The sample was composed of 48 male rats, with 12 weeks old and weighing approximately of 300 grams, who underwent the administration of zoledronic acid, 0.6 mg / kg every 28 days with a total of 5 doses. The animals were divided into four groups, each consisting of 12 animals; 2 treatment groups AZ and AZ-experimental (AZ-exp) and 2 control groups CO and CO-experimental (CO-exp) with sodium chloride administration 0.9% in the same volume and frequency of zoledronic acid. All solutions were administered intraperitoneally. The AZ-exp group and the CO-exp group underwent extractions rights upper molars and the bone defect was performed in the left femur 45 days after the first application of the solutions. Euthanasia of animals occurred after 150 days from the beginning of the experiment. Histological evaluation was performed through quantitative and qualitative analysis checked the presence of bone sequestration, osteonecrosis area and whole bone areas by means of optical microscopy by hematoxylin-eosin staining. Quantitative analysis of mRNA expression of proteins involved in bone repair by polymerase chain reaction method in real time (RealTimePCR) was also performed: osteoclasts (RANK, RANKL and OPG), osteoblasts (ALPL and OCN) osteocytes (PMD-1 and PHEX) and vascularization (VEGF). Only the group with administration of AZ and performing tooth extractions presented bone sequestration and significantly larger areas of osteonecrosis when compared to animals with extraction and without AZ administration. There were no areas of osteonecrosis of the femoral analysis. The evaluation of the whole bone showed more bone in animals undergoing surgeries and AZ administration but there was no statistical significance. Molecular analysis, AZ administration and the performance of tooth extractions and bone defect changed the expression of markers for osteoclasts. The AZ administration associated with surgical procedures increased the expression of early markers of osteoblastogenesis and decreased the late expression of osteoblasts. The expression of osteocytes markers was lower after AZ administration and maxillary tooth extractions; however, there was an increase in the expression of these markers in the femur. The performance of tooth extractions and bone defects in the femur increased VEGF expression in animals with and without administration of AZ. These results show the interference of zoledronic acid on bone repair of the sockets and bone defects in the femurs, causing incidence of osteonecrosis of the upper jaw, delayed bone remodeling, and no femoral osteonecrosis injuries. The presence of osteonecrosis injuries in the upper jaw can be the consequence of the delay on bone remodeling, evidenced by the change in the markers expression for osteoclasts and osteoblasts, and they cause the decreased in protein expression by osteocytes.

Bakgrund: Vid diagnostik av käkbenslesioner skickas ibland en remiss till röntgenspecialist för ett utlåtande. Röntgenspecialisten ger en eller flera tentativa diagnoser vilka kan underlätta vid beslut om behandling. Efter behandlingen skickas en biopsi till patolog för att erhålla en patologanatomisk diagnos. Syftet med denna studie är att 1) utreda hur väl tentativa röntgenologiska diagnoser överensstämmer med patologanatomiska diagnoser av käkbenslesioner och 2) utvärdera hur ofta röntgenutlåtanden kan leda till felaktig behandling av käkbenslesioner.Material och metod: Röntgenutlåtanden och motsvarande patologanatomiska diagnoser jämfördes retrospektivt under en tioårsperiod för nio vanliga käkbenslesioner. För varje käkbenslesion räknades antalet korrekta respektive inkorrekta röntgenologiska diagnoser som erhållits. Utöver detta jämfördes även den förväntade behandlingen av varje tentativ röntgendiagnos med den förväntade behandlingen av den korrekta patologanatomiska diagnosen. Utifrån detta gjordes sedan en bedömning av huruvida röntgenutlåtandet kunde leda till underbehandling, korrekt behandling eller överbehandling. Resultat: Röntgendiagnoserna överensstämde med de patologanatomiska diagnoserna i 191 av 394 fall (48%). Därutöver gav 61 röntgenutlåtanden (16%) den korrekta diagnosen tillsammans med en eller flera inkorrekta diagnoser. 142 utlåtanden (36%) gav endast en eller flera inkorrekta diagnoser. Drygt en fjärdedel av alla röntgenutlåtanden bedömdes kunna leda till felaktig behandling. Konklusion: Resultaten indikerar en anmärkningsvärd diskrepans mellan de tentativa röntgendiagnoserna och de patologanatomiska diagnoserna av de undersökta käkbenslesionerna. När röntgenspecialisten ger fler än en tentativ diagnos finns en ökad risk för överbehandling vilket kan leda till onödigt lidande för patienten samt en ökad kostnad för både patienten och samhället. Baserat på dessa resultat bör röntgenspecialisternas rutiner för hur många tentativa diagnoser de anger i sina röntgenutlåtanden ses över. / Background: When diagnosing jaw lesions, a referral may be sent to a radiologist for a radiographic report. The radiologist offers one or several tentative diagnoses, which help form the basis for treatment. After treatment a biopsy is sent to a pathologist for a pathoanatomical diagnosis. The aim of this study is to 1) determine the correspondence between tentative radiographic diagnoses and pathoanatomical diagnoses of jaw lesions and 2) evaluate how frequently radiographic reports may lead to incorrect treatment of jaw lesions. Materials and methods: Radiographic reports and pathoanatomical diagnoses of nine common jaw lesions were compared retrospectively over a ten-year period. The numbers of correct and incorrect tentative radiographic diagnoses were counted for each lesion. In addition, the expected treatments of the tentative radiographic diagnoses were compared with the expected treatments of the correct pathoanatomical diagnoses. Each report was then categorized as leading to undertreatment, correct treatment or overtreatment.Results: The radiographic reports corresponded with the pathoanatomical diagnoses in 191 out of 394 cases (48%). In addition, 61 radiographic reports (16%) stated the correct diagnosis along with one or several incorrect diagnoses. 142 reports (36%) only stated one or several incorrect diagnoses. Just over a quarter of the radiographic reports were deemed to lead to incorrect treatment. Conclusion: The results indicate a remarkable discrepancy between tentative radiographic diagnoses and pathoanatomical diagnoses for the studied jaw lesions. There is a tendency towards overtreatment when more than one tentative diagnosis is stated in the radiographic reports. Overtreatment may lead to unnecessary suffering for the patient and financial loss for both the patient and society. Based on these results, radiologists should review their practice of stating several tentative diagnoses in their reports.

Zysten und zystenähnliche Erkrankungen sind häufig auftretende Krankheiten des Ober- sowie Unterkiefers. Das Ziel der durchgeführten Studie war es, die Prävalenz und die topografische Verteilung von Kieferzysten für eine Leipziger Population darzustellen. Dafür wurden aus 4245 oralpathologischen Fällen der Jahre 2000 bis 2010 jene herausgefiltert, die einen Bezug zur Zielstellung aufwiesen. Es wurden Daten von 1336 Fällen (31,5%) ermittelt und retrospektiv ausgewertet. Die Auswertung erfolgte an Hand folgender Merkmale: Alter, histologische Beurteilung, Geschlecht, Größe, Lokalisation, Vorliegen eines Rezidivs, sowie entzündliche oder regressive Veränderung. Mit 932 Fällen stellten radikuläre Zysten die größte Gruppe (69,8%), gefolgt von follikulären Zysten (n=257; 19,2%), keratozystischen odontogenen Tumoren (n=62; 4,6%) sowie Residualzysten (n=54; 4,0%). Jeweils mit Anteilen kleiner als 1% wurden die folgenden Entitäten festgestellt: Ameloblastome (n=12), laterale parodontale Zysten (n=5), solitäre Knochenzysten (n=5), nasopalatinale Zysten (n=3), aneurysmatische Knochenzysten (n=2), paradentale Zysten (n=2), sowie Eruptionszysten als auch glanduläre odontogene Zysten (jeweils n=1). Mit 62,4% aller Patienten waren Männer signifikant häufiger betroffen (833 zu 502). 52,5% aller Zysten traten im Unterkiefer auf, damit signifikant öfter als im Oberkiefer (701 zu 603 Fälle). Die Altersspannweite reichte von einem bis zu 92 Jahren. Durchschnittliche trat eine Zyste erstmals mit 42,86 ± 17,30 Jahre (n=1335) auf. Weiterhin betrug die Durchschnittsgröße einer Zyste 1,17 ± 0,9 cm (n=1327). In 1101 Fällen (82,5%) konnte eine entzündliche Komponente histologisch nachgewiesen werden, vordergründig bei radikulären (n=932) sowie follikulären Zysten (n=106). Rezidive einer Erkrankung wurden in 17 Fällen beschrieben, besonders oft in keratozystischen odontogen Tumoren (n=8) sowie Ameloblastomen (n=4). Regressive Veränderungen konnten an 9 Zysten festgestellt werden, mit 4 Fällen am häufigsten bei keratozystischen odontogenen Tumoren. Die Prävalenz als auch die Verteilung der Kieferzysten in Leipzig zeigte sich in weiten Teilen sehr ähnlich zu den aus anderen Populationen.

Dysarthria is one of the most common signs of speech impairment in the cerebral palsy (CP) population. Facilitating strategies for speech enhancement in this population often include training on speech breathing. Treatment efficacy studies with cross-system measures in this population are needed for improved understanding and management of the interrelationship between respiratory, phonatory, and articulatory systems. The purpose of this study was to investigate the effect of breath group control on the coordination of articulatory and phonatory muscles and the acoustic measures related to speech and voice quality. A simultaneous acoustic, electroglottographic (EGG), and marker-based facial tracking recording system was employed to monitor the speech production behaviors of four adults with CP and 16 neurologically healthy controls. Subjects were instructed to perform three tasks, each containing speech targets with a voiceless plosive (/p/, /t/, or /k/) preceding a vowel (/i/, /a/, /u/, or /ɔ/). Task 1 consisted of a short reading passage embedded with target vowels without cueing from breath group markers. Task 2 included reading a series of monosyllabic and 3-syllable or 5-syllable non-speech words with the speech targets. Task 3 included reading the same short passage from Task 1 with cueing from breath group markers separating the passage into phrases with no more than five syllables per phrase. Measures from the acoustic, EGG and facial tracking recordings of the first and last syllable of all syllable trains produced in the non-speech task and the target vowels in the passage reading task were examined. Acoustic measures included voice onset time (VOT), vowel duration, fundamental frequency (F0), percent jitter (%jitter), percent shimmer (%shimmer), signal-to-noise ratio (SNR), and frequencies of Formants one and two (F1 and F2). EGG measures included speed quotient (SQ) and open quotient (OQ). Facial tracking measures consisted of maximum jaw displacement. Individual and averaged data were submitted to a series of two-way Analysis of Variances (ANOVAs) or two-way Repeated Measures ANOVAs to determine the effects of the relative position of an utterance in the breath group and the place of articulation of the consonants involved. In addition, mean vowel spaces derived from all three tasks were examined. Results revealed significant changes of VOT, F1, F2, SNR and SQ as a function of position. Significant changes of VOT, vowel duration, F2, F0, %jitter, %shimmer, and maximum jaw displacement as a function of place of articulation were also evident. In particular, breath group control was found to result in expansion of vowel space, especially for individuals with CP. These findings suggest that proper phrasing enhances articulatory and phonatory stability, providing empirical evidences in support of its usage in treating individuals with CP.

Die Bisphosphonat- assoziierte Kiefernekrose (BONJ) gewinnt seit ihrer Erstbeschreibung 2003 durch die steigenden Verschreibungszahlen der Bisphosphonate stetig an Bedeutung. Da eine effektive Therapie der BONJ nach wie vor sehr schwierig ist, liegt das Hauptaugenmerk in der Prävention und frühzeitigen Erkennung der Erkrankung. Die vorliegende Arbeit beschäftigt sich daher vor allem mit dem Stellenwert der Dental- CT in der Diagnostik und Früherkennung der BONJ. Dafür wurden die nativen Dental- CT- Aufnahmen von 99 Patienten unter Bisphosphonattherapie retrospektiv nach im Vorfeld klar definierten qualitativen, quantitativen und halbquantitativen Kriterien neu beurteilt. Entgegen der Literatur und den aktuellen Empfehlungen der AWMF erwies sich die CT zur Früherkennung und stadiengerechten Dokumentation der BONJ als hervorragend geeignet. Bereits unspezifische klinische Entzündungszeichen können auf ein Frühstadium der BONJ hindeuten. Das radiologische Hauptsymptom der Hypersklerosierung stellt dabei ein Durchgangsstadium der BONJ dar. Mit Fortschreiten der Erkrankung kommt es zu einem zunehmend heterogenen Erscheinungsbild mit lokaler Hypersklerosierung, grobwabiger Spongiosastruktur, Osteolysen und Sequestern. Es ist erstmals gelungen die wichtigsten radiologischen Zeichen einer BONJ zu objektivieren und die große biologische Variabilität exakt abzubilden. Bemerkenswert war zudem ein signifikant hochgradigerer Befall der Mandibula durch die BONJ. Die Dental- CT ist damit für die Betreuung der betroffenen Patienten die Methode der 1. Wahl.

Orientador: Krunislave Antonio Nobilo / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-07-23T07:35:01Z (GMT). No. of bitstreams: 1 Passos_LuizEgydioTeixeiraLeite_M.pdf: 3747769 bytes, checksum: aef62d7ac14ff5b83794a468a2a3e16f (MD5) Previous issue date: 1997 / Resumo: Estudos têm demonstrado que a perda da DVO levam a diminuição dos movimentos mandibulares. Propusemos neste estudo analisar os movimentos mandibulares horizontais, ântero-posterior (A/P), lateral direita (L/D), lateral esquerda (L/E) através de registros intra-orais em dez pacientes sem perda da DVO (controle) e dez desdentados com perda da DVO entre 11 a 12 mm. Os modelos foram montados em articulador semi-ajustável e confeccionados os registros intra-orais, um para o grupo controle e dois registros (R 'IND. 1' e 'R IND. 2') para o grupo com DVO alterada sendo 'R IND. 1' com perda da DVO e 'R IND. 2' com a DVO recuperada. Os valores médios da extensão dos movimentos foram A/P = 12,591 mm, LD = 10,665 mm, LE = 10,562 mm. Para o grupo com perda da DVO foram: 'R IND. 1' - A/P = 08,107 mm LD = 06,100 mm, LE = 06,720 e 'R IND. 2' - A/P = - 10,167 mm, LD = 9,308 mm, LE = 9,285 mm. Aplicando-se o teste T pareado no segundo grupo, houve diferença significativa ao nível de 5% entre 'R IND. 1' e 'R IND. 2' e aplicando-se o teste T em 'R IND. 2' e o grupo controle não houve diferença ao nível de 5%. Desta forma podemos concluir que pacientes desdentados totais com perda da DVO, apresentam uma redução da amplitude dos movimentos mandibulares que podem ser resgatados pela recuperação da dimensão vertical da face / Abstract: Studies have demonstrated that the loss of the VDO, result in decreasing of mandibulars movement. We have proposed in to study to analyse the horizontal mandibulars movement, (P/R = protusivelretrusive, R = right, L = leA), using intra-oral devices in twenty edentulou pacients, with half of them presenting no loss of the VDO between 10 an 11 mm. The complete dentures was moulded and the measures were reproduced with the facial arco The cast were prepared on the semi adjustable articulador and the intra oral devices were manufactured, being one for the contros group and two ones ('R IND. 1' and 'R IND. 2') for group with the altered VDO, being 'R IND. 1' with VDO loss and 'R IND. 2' with recovered VDO. The medium values of the movements extensions presented by the control group were: P/R=12,591; R=10,665; L=10,562. For the group with VDO loss the values were: P/R=08,107; R=06,100; L=06,720 and P/R=10,167; R=09,308; L=09,285, for the 'R IND. 1' and 'R IND. 2' group respectively. Applyng the paired T test, there was a significa tive difference at leveI of 5% between 'R IND. 1' and 'R IND. 2' for the mandibular border moviments we should restore the physiological VDO, its decrease result in reduction of the horizontal. Was conclued that, for recuring the mandibulars moviments of the total edentulous pacients, second group and no significative difference at this level for the 'R IND. 2' and the control grou / Mestrado / Fisiologia e Biofisica do Sistema Estomatognatico / Mestre em Odontologia

Tooth extraction is necessary when there is advanced decay, significance trauma or injury to the oral cavity, misalignment associated with crowded teeth or even, poor eruption of third molars. Typically, during extraction procedures, bone grafting material is inserted to minimize bone loss. Bone grafting has become a standard procedure in dentistry and an essential component in modern medicine. The practice started nearly 350 years ago when a Dutch doctor in 1668 performed the first and successful bone grafting operation. Currently, research studies are ongoing to enhance the success and viability of dental reconstruction. This thesis examines the effect of varying dental graft techniques and methodology on the stability and long-term effect on the jawbone. These techniques include five primary bone grafting methods, onlay, inlay, ridge expansion, distracted osteogenesis and guided bone regeneration (GBR) have been approved to enhance the outcome of dental implants. The review has presented the documented limitations and viability of each method. In this paper, the alternatives to bone grafting have also been elaborated. Based on the findings depicted in this research, the following recommendations will assist in achieving the best jawbone outcomes in long-term and short-term assessments. These recommendations are as follows, a proper evaluation of each patient to determine their health condition. The nature of the infection, injury, and trauma that led to the extraction of the tooth should be well documented. The selection of technique pertaining to dental restoration, functionality, and aesthetic needs are of primary factors considered. A proper clinical follow-up and monitoring of recovery process is an essential part that contributes to valid results. Finally, patient awareness is essential as well. The study found out that although some of the bone grafting techniques have shown a high survival rate, significant alveolar bone quality and quantity, and success of the implants, several reports that the use of bone grafts and implants is a practice that will still dominate dental surgery and attract more clinical assessments.