Orientador: Luis Augusto Passeri / Texto em português e inglês / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-25T07:56:16Z (GMT). No. of bitstreams: 1 MunanteCardenas_JoseLuis_D.pdf: 3765952 bytes, checksum: 97597698c84a612dd3f881f11b254a15 (MD5) Previous issue date: 2014 / Resumo: Este estudo teve como objetivo avaliar as características epidemiológicas de casos envolvendo fraturas mandibulares e o comportamento mecânico de quatro diferentes métodos de fixação de fraturas de ângulo mandibular. Foi realizado um levantamento epidemiológico sobre os casos de fraturas de mandíbula tratados pela Área de Cirurgia Plástica do Hospital das Clínicas da Universidade Estadual de Campinas (Unicamp). Foram analisados os prontuários de 119 pacientes tratados entre janeiro de 2006 e dezembro de 2011. As fraturas identificadas afetaram principalmente pacientes jovens do gênero masculino. Os acidentes de trânsito causaram o maior número de fraturas, sendo os acidentes de motocicleta a causa mais comum. As regiões mandibulares mais envolvidas foram a parassínfise e o ângulo. O tratamento cirúrgico foi aplicado na grande maioria dos casos. Complicações ocorreram em 36 pacientes (30,2%). As complicações no ângulo mandibular representaram 27% dos casos. A gravidade do trauma e a pouca colaboração dos pacientes foram fatores que contribuíram para o desenvolvimento de complicações pós-operatórias. Para a avaliação mecânica foram utilizadas quarenta réplicas de mandíbulas confeccionadas em poliuretano. As amostras foram divididas em quatro grupos com diferentes métodos de fixação: uma miniplaca, duas miniplacas dispostas paralelamente, uma miniplaca grade de 4 furos e uma miniplaca grade de 8 furos, todos do sistema de 2,0mm. Os grupos foram submetidos ao teste mecânico em uma máquina de ensaio universal, Instron 4411 (Instron Corp, Norwood, MA), recebendo uma carga vertical linear na região do incisivo e do primeiro molar. A técnica de duas placas paralelas apresentou resistência estatisticamente maior que todos os outros métodos de fixação. Entretanto, as placas grade de 4 furos não apresentaram diferença estatisticamente significante em relação ao grupo de uma miniplaca. As placas grade de 8 furos apresentaram os menores valores de resistência. Desta forma, a técnica de duas placas apresentou melhor comportamento mecânico para a fixação de fraturas de ângulo mandibular / Abstract: The objectives of this study were evaluate the epidemiological characteristics of cases involving mandibular fractures and to evaluate the mechanical behavior of four different methods of fixation of fractures of the mandibular angle. An epidemiological survey on cases of mandibular fractures treated by the Department of Plastic Surgery, at the Clinical Hospital of University of Campinas, was performed. The medical records of 119 patients treated between January 2006 and December 2011 were analyzed. The fractures mainly affected young male patients. Road traffic accidents caused the largest number of fractures, being the motorcycle accidents the most common cause. The most affected regions were the mandibular angle and parasymphysis. Surgical treatment was applied in most cases. Complications occurred in 36 patients (30.2 %). Complications in mandibular angle accounted for 27 % of cases. The severity of the trauma and uncooperative patients were factors that contributed to the development of postoperative complications. To the mechanical evaluation, forty mandible replicas made of polyurethane were used. The samples were divided into four groups with different fixation methods: one miniplate, two parallel miniplates, a 3D miniplates with 4 holes and a 3D miniplate with 8 holes, all of them of a 2.0mm system. Each group was subjected to linear vertical loading at the incisal and molar region by an Instron 4411 mechanical testing unit (Instron Corp, Norwood, MA). The technique of two parallel miniplates showed statistically greater resistance than all other fixation methods. No statistically significant difference was observed in 3D miniplates with 4 holes in relation to the group of one miniplate. The 3DPP group showed lower values of strength. Thus, the technique of two miniplates showed better mechanical behavior for the fixation of the mandibular angle fractures / Doutorado / Fisiopatologia Cirúrgica / Doutor em Ciências

Orientador: Roger William Fernandes Moreira / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-20T05:27:44Z (GMT). No. of bitstreams: 1 Maliska_MaximianaCristinadeSouza_M.pdf: 978865 bytes, checksum: bda5de7a557c24f7bad2db92cbbead9f (MD5) Previous issue date: 2012 / Resumo: Os resultados em cirurgia ortognática dependem de um diagnóstico acurado e planejamento correto, portanto a cirurgia de modelo deverá ser com a menor quantidade de erros possível. Sabe-se que o uso do arco facial leva a diversos erros de aquisição do posicionamento tridimensional da maxila. Este estudo visou analisar se a alteração da angulação do plano oclusal influencia no resultado final após a cirurgia de modelos em avanços maxilares. Para esta análise dois tipos de avanço foram abordados: de 4 e de 8 milímetros. Foram montados 20 modelos maxilares com angulação de plano oclusal de 13 graus (grupo controle) e 20 modelos maxilares com angulação de 7 graus (grupo estudo) para cada grupo de avanço maxilar. A cirurgia de modelo com o respectivo avanço maxilar foi realizada utilizando-se o plano de 13 graus para a confecção do guia intermediário. Os 40 modelos foram remontados utilizando-se o mesmo guia. Mensurações foram realizadas com paquímetro digital utilizando plataforma de Erickson mais base metálica nos três planos: vertical, anteroposterior e médiolateral. A análise estatística revelou resultados significativos nos três planos. A alteração da angulação do plano oclusal em menos 6 graus alterou o resultado final nas medidas verticais: molar direito do grupo de avanço maxilar de 4 milímetros (p<0.0001) e molar esquerdo dos dois grupos de avanço (p<0.0001); na medida anteroposterior a partir do incisivo central superior do grupo de avanço de 4 milímetros (p<0.005) e do grupo de 8 milímetros (p<0.0001). Embora resultados estatisticamente significativos tenham sido encontrados, nenhuma significância clínica pode ser observada / Abstract: This study investigated whether an occlusal plane error of acquisition can influence in the treatment planning and result of maxillary advancement in double-jaw surgeries. Advancement of 8 and 4 millimeters were studied in different groups. For each group 20 maxillary models were mounted by a 13 degrees platform with superior articulator arm (control group) and another 20 models mounted with minus 6 degrees (study group). Intermediate splint was obtained by cast surgery performed in the control group. All the 40 maxillary models were remounted with this intermediate splint. Measurements in vertical and anteroposterior planes were accomplished pre and post-operatively by digital caliper rule and Erickson's platform. Statistical analysis showed significant results in all planes. The alteration of occlusal plane from 13 degrees to 7 degrees modified the final result in vertical measurements: right molar from group of 4 mm advancement (p<0.0001) and left molar from two groups of advancement (p<0.0001); in anteroposterior measurements: maxillary incisor from 4 mm of advancement (p<0.005) and 8 mm of advancement (p<0.0001). Notwithstanding the importance of statistical findings, this study was limited by a range of 4 mm of advancement and a range of 6 degrees of angle alteration because the sample were chosen by the laboratorial methodology. Clinical studies evolving these questions must be supplied in scientific literature / Mestrado / Cirurgia e Traumatologia Buco-Maxilo-Faciais / Mestre em Clínica Odontológica

Orientador: Márcio de Moraes / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-20T12:59:05Z (GMT). No. of bitstreams: 1 Ritto_FabioGamboa_D.pdf: 4854546 bytes, checksum: 9fb3a4496d84ac69f450c97408ae204f (MD5) Previous issue date: 2012 / Resumo: O objetivo deste trabalho foi avaliar a precisão do posicionamento maxilar em cirurgias ortognáticas bimaxilares utilizando sequência cirúrgica convencional e sequência invertida, isto é, quando a mandíbula foi osteotomizada e fixada antes da maxila. Neste estudo retrospectivo, 80 telerradiografias obtidas em norma lateral de pacientes submeditos à cirurgia ortognática foram analisadas, sendo 40 obtidas no período pré-operatório e 40 no pós-operatório. A amostra foi dividida em 2 grupos de acordo com a sequência cirúrgica executada. No Grupo 1 constaram as radiografias de pacientes submetidos à cirurgia através da sequência convencional, enquanto no grupo 2 constaram as radiografias dos pacientes submetidos à cirurgia pela sequência invertida. Em ambos os grupos foi analisada posição final do incisivo central superior, tanto no sentido vertical quanto no ântero-posterior, sendo este resultado comparado com o que fora planejado, na busca da precisão cirúrgica. O resultado encontrado nos grupos 1 e 2 foram então confrontados na busca de diferenças entre as duas técnicas. Foi testada a hipótese nula de que não havia diferença entre os grupos analisados. Após aplicado o teste t de Welch para comparação das médias das diferenças entre o desejado e o obtido nos grupos 1 e 2, considerando significância estatística de 5% (alpha) e um teste bi-caudal, chegou-se a evidência estatística de que a hipótese não nula foi rejeitada dados os resultados obtidos das amostras (p>0,05). Sendo assim, não houve diferença no grau de precisão do posicionamento maxilar entre os grupos. Concluiu-se que tanto a sequência cirúrgica convencional quanto a sequência cirúrgica invertida mostraram ser técnicas confiáveis no posicionamento maxilar após osteotomia. tipo Le Fort I / Abstract: The objective of this study was to evaluate maxillary positioning accuracy of double jaw orthognathic surgery using conventional surgical sequence and inverted sequencing, ie, when the mandible was osteotomized and fixed prior to the jaw. In this retrospective study, 80 lateral radiographs obtained in patients that underwent orthognathic surgery were analyzed, 40 obtained in the preoperative and 40 in the postoperative period. The sample was divided into two groups according to the surgical sequence performed. Group 1 consisted of the radiographs of patients submitted to conventional surgical sequence, while group 2 consisted of the radiographs of patients that underwent surgery by the inverted sequencing. In both groups the final position of the maxillary central incisor was analyzed (in the vertical and anteroposterior planes), and this result was compared with what was planned in the pursuit of surgical precision. The results found in groups 1 and 2 were then compared in the search of differences between the two techniques. The null hypothesis, which stated that there was no difference between the groups, was tested. After applying the Welch t test for comparison of mean differences between the desired and obtained in groups 1 and 2, considering a statistical significance of 5% (alpha) and a two-tailed test, the null hypothesis was not rejected given the results of the samples (p> 0.05). Thus, there was no difference in the accuracy of maxillary positioning between the groups. It was concluded that the conventional surgical sequence as well as the inverted sequencing proved to be reliable in positioning the maxilla after Le Fort I osteotomy / Doutorado / Cirurgia e Traumatologia Buco-Maxilo-Faciais / Doutor em Clínica Odontológica

Magister Chirurgiae Dentium - MChD / This is a retrospective study of malignant tumours of the maxillofacial and oral region in children that presented over a 20 year period (1973 to 1993) at the Red Cross War Memorial Children's Hospital and Groote Schuur Hospital, Cape Town. Of the 352 children that were treated for a malignant tumour arising from various anatomic sites in the head and neck region, 30 were found to have had maxillofacial and oral involvement. This represented an incidence of 8,5%. Histologically, the majority of the tumours were non-odontogenic and mesenchymal in origin. The rhabdomyosarcoma was found to be the most common neoplasm, followed by the Burkitt's lymphoma. The age range was 6 months to 13.8 years (mean age 5.7 years). Males were more commonly affected than females, with a ratio of 1.3:1. There were 26 (86,7%) black patients and 4 (13,3%) white patients, representing a ratio of 6.5:1. Fifty percent of the cases were from the Eastern Cape. The mandible and the maxilla were the most common sites to be involved, followed by the soft tissues of the face. The most common presenting symptom was a painless swelling (73,3%) of the face. Twenty percent of the patients had "floating" or loose teeth. Radiographic features in the jaws were poorly circumscribed destructive lytic lesions with displacement of teeth. Histologic type was found to be the most significant variable affecting the outcome, with the Burkitt's lymphomas having the best prognosis and the rhabdomysarcomas the worst. The most common cause of death was metastases to the lungs. It is concluded that although malignant tumours of the maxillofacial and oral region in children are rare, their prognosis is poor. Therefore, any child presenting with a facial swelling should be viewed with suspicion.

Since the late 20th century, breakthroughs in technology have been occurring expeditiously. Indeed, technological innovations have provided the betterment of many aspects of life and ensured humans’ appropriate forms of evolution and civilization. It is safe to claim that medicine has advanced within the past few decades, especially with the upbringing of technological innovations. The world of medicine would not have experienced its recent breakthroughs and profound discoveries without utilizing the available technology. The improvements observed in medicine and technology resulted in better providing of healthcare. Customizing treatments for each patient is now possible. One method of applying customization is through 3D printing of materials such as artificial prosthetics, tissues, and organs. This literature review analyzes 3D printing by stating definitions, assessing its history, discussing its different applications and closing with evaluating future directions. 3D printing first appeared in the late 20th century, and its primary purpose was to design and manufacture products efficiently and accurately. Traditional production of structures involves subtractive manufacturing (carving, cutting, and other methods of reshaping materials) to achieve desired products, whereas 3D printers implement additive manufacturing (a layer-by-layer approach). This provides less time, greater accuracy, and labor-free fabrication of products. Computerized software is one of the essential parts of 3D printing, and functions include designing, scaling, visualizing, controlling production frequency, and many more. In medical applications, the software may require CT scans, cone beam computed tomography, and intraoral scanners (for dental applications). The 3D printing techniques identified in this review are generally applied in oral and maxillofacial procedures—stereolithography, which constructs a product layer-by-layer through curing liquid resin using a UV laser. Digital light projection is a method similar to stereolithography, with a few differences, such as using a UV light instead of a laser and using a liquid crystal display panel. Fused deposition modeling is a technique that melts plastic filaments and extrudes them through a nozzle to form a structure in a layer-by-layer fashion. Selective laser sintering is also similar to stereolithography, where it uses a laser to form an object layer by layer, but the material is a thin layer of plastic powder instead of liquid resin. The power binder printing technique applies droplets onto powdered materials, adhering and forming layers as designed via computerized software. Lastly, computed axial lithography is similar to digital light projection, except the light is projected from many angles at once instead of one layer at a time. The main objectives of this literature review are to investigate each technique, discuss the advantages and disadvantages, and list the commonly applied areas in medicine for each. Also, this review evaluates the current limitations experienced when using 3D printers and suggestions for overcoming them. Some limitations include, but are not limited to, excessive time allocated for producing specific structures, accurate capturing of surgical sites, use of appropriate materials that form printed structures, cost, and deficiencies of reported data. Lastly, this literature review assesses the future projections. The future holds promising breakthroughs in 3D printing technology, including the fabrication of dental stem cells, operating artificial organs, complex vascular tissues, customized artificial alveolar structures for oral and intracranial procedures, and regeneration of periodontal tissues. These projections may occur by overcoming the most reported limitations. Medicine is digitizing rapidly and will continue adapting to the latest technological inventions. The current efforts to advance 3D printing technology will likely positively impact the advancement of many fields, including healthcare, increase chances of positive postoperative outcomes, and potentially combat many health issues society faces today. Professionals across disciplines must come together to further research and educate curriculums to revolve around the innovative technologies to continuing education courses related to 3-D printing technologies.

京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第20754号 / 医博第4284号 / 新制||医||1024(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 松田 秀一, 教授 開 祐司, 教授 妻木 範行 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

Indiana University-Purdue University Indianapolis (IUPUI) / The purpose of this study was to investigate the effect of nano ceramic fiber fillers on the physical properties of VST-50HD silicone maxillofacial prosthesis. Nano alumina fibers at 2 percent, 4-percent, and 6-percent wt were mixed into the VST-50HD silicone elastomer (Factor II Inc., Lakeside, AZ), a commercially-available poly(dimethylsiloxanes). Ten dumb-bell-shaped specimens were used to determine the tensile strength according to ISO 37:2005 and elongation at fracture. Ten trouser-shaped test pieces were used to determine the tear resistance according to ISO 34-1:2004. Shore A test method was used to measure the hardness of the material. The data collected from all quantitative studies of the modified silicones were analyzed using one-way ANOVA with concentration of nano ceramic fiber as the main variable. Specimens from VST- 50HD were also made and tested as control. Results: The mean values for tensile strength (MPa) of control group, 2-percent, 4-percent, and 6-percent reinforced nano ceramic fiber fillers were from 3.43 ± 0.12 to 5.48 ± 0.71. Tear strength (MPa) were from 2.34 ± 0.37 to 5.01 ± 0.39. Elongations at fracture were from 699.66 ± 43.69 to 793.51 ± 57.27. Shore A hardness were from 25.76 ± 2.18 to 38.76 ± 1.83. Conclusion: There was a significant difference (p < 0.001) in the mean tensile, tear and Shore A hardness strengths between the control group and 2-percent, 4-percent, and 6-percent percent reinforced nano ceramic fiber fillers; however, there was not a significant difference (p > 0.05) between 2-percent, 4-percent, and 6-percent reinforced nano ceramic fiber fillers. There was a significant difference (p < 0.001) in the mean elongation at fracture between the 2-percent and control group, 4-percent, and 6-percent reinforced nano ceramic fiber fillers; however, there was not a significant difference (p > 0.05) between control group, 4-percent, and 6-percent reinforced nano ceramic fiber fillers. The properties of the experiment were all lower than the control. Further research is needed to determine the appropriate material and amount of dispersing agent, coupling agent, and determination of the hydprophilicity of the nano ceramic fiber fillers with great emphasis on the dispersing agent.

In computational imaging, data acquired by sampling the same scene or object at different times or from different orientations result in images in different coordinate systems. Registration is a crucial step in order to be able to compare, integrate and fuse the data obtained from different measurements. Tomography is the method of imaging a single plane or slice of an object. A Computed Tomography (CT) scan, also known as a CAT scan (Computed Axial Tomography scan), is a Helical Tomography, which traditionally produces a 2D image of the structures in a thin section of the body. It uses X-ray, which is ionizing radiation. Although the actual dose is typically low, repeated scans should be limited. In dentistry, implant dentistry in specific, there is a need for 3D visualization of internal anatomy. The internal visualization is mainly based on CT scanning technologies. The most important technological advancement which dramatically enhanced the clinician's ability to diagnose, treat, and plan dental implants has been the CT scan. Advanced 3D modeling and visualization techniques permit highly refined and accurate assessment of the CT scan data. However, in addition to imperfections of the instrument and the imaging process, it is not uncommon to encounter other unwanted artifacts in the form of bright regions, flares and erroneous pixels due to dental bridges, metal braces, etc. Currently, removing and cleaning up the data from acquisition backscattering imperfections and unwanted artifacts is performed manually, which is as good as the experience level of the technician. On the other hand the process is error prone, since the editing process needs to be performed image by image. We address some of these issues by proposing novel registration methods and using stonecast models of patient's dental imprint as reference ground truth data. Stone-cast models were originally used by dentists to make complete or partial dentures. The CT scan of such stone-cast models can be used to automatically guide the cleaning of patients' CT scans from defects or unwanted artifacts, and also as an automatic segmentation system for the outliers of the CT scan data without use of stone-cast models. Segmented data is subsequently used to clean the data from artifacts using a new proposed 3D inpainting approach.

No description available.

Inledning: Krig och materiel utvecklas konstant. Detta resulterar i olika typer av skador. Tidigare litteraturstudier uppvisar en prevalens av huvud-, ansikts- och halsskador (HAHS) under 1900-talet på mellan 16% och 43% i krig och krigsliknande situationer. Ytan av huvudet, ansiktet och halsen är dock inte mer än cirka 9% av den totala kroppsytan. På senare år har en ökning i användandet av hemmagjorda bomber, eller “improvised explosive devices” (IED), påvisat en uppgång av prevalensen gällande HAHS.Syfte: Att undersöka andelen HAHS i det totala skadepanoramet i krig och krigsliknande situationer från år 2000 till 2010. Metod: En systematisk litteratursökning genomfördes. Resultat: Tio artiklar inkluderades. Dessa redovisade resultat från konflikter och attacker i Afghanistan, Israel, Irak och London och andelen HAHS sträckte sig mellan 6,4% och 39,4% och resulterade i en genomsnittlig prevalens på 25%. Den stora spridningen i resultatet är troligtvis ett tecken på svårigheterna att jämföra olika konflikter med varandra. Olika anatomiska inklusioner och exklusioner gör det svårt att jämföra resultat. Den riktiga prevalensen av dessa typer av skador är därför, troligen, högre. Vanliga och specifika maxillofaciala skador presenteras även.Slutsatser: Explosioner är den vanligaste oraken till maxillofaciala skador. Mjukvävnadsskador i ansiktet är den vanligaste skadan och den vanligaste hårdvävnadsskadan är fraktur i den nedre tredjedelen av ansiktet. Då användandet av IED ökar är det troligt att prevalensen av HAHS ökar i framtiden. / Introduction: War, weaponry and armour are constantly evolving. This results in variations in types of injuries occurring. Previous reviews show an incidence of head, face, and neck injuries (HFNI) during the 20th century ranging from 16% to 43% in war and war type situations but, anatomically, the head, face, and neck accounts for approximately 9% of the total body area. In recent years the use of Improvised Explosive Devices (IED) in terrorist conflict has risen and this has been shown to give a rise in the prevalence of HFNI.Aim: To examine the proportion of HFNI in the total injury panorama of soldiers and civilians wounded in war type situations from 2000 to 2010. Methods: A systematic literature search was conducted according to Goodman. Results: Ten articles concerning conflicts and attacks in Afghanistan, Israel, Iraq and London were included and presented an incidence of HFNI on 25% (mean, range 6.4-39.4%).The wide spread in results is caused of different anatomical exclusions and inclusions but also because of the difficulties in comparing different conflicts to each other. The real mean incidence is therefore, most likely, higher. Common and particular maxillofacial war injuries are also discussed.Conclusion: Explosive devices account for the bulk of injury mechanism. Facial lacerations are the most common HFNI and the majority of fractures occur in the lower third of the face. A rise in the use of IED will mostly likely cause an increase in the prevalence of HFNI in the future.