Please read the abstract in the section 00front of this document / Dissertation (MChD (Orthodontics))--University of Pretoria, 2007. / Orthodontics / unrestricted

Magister Scientiae Dentium - MSc(Dent) / General dentists in practice (both public and private) are often reluctant to perform interceptive orthodontic procedures on patients that present to their practices. As interceptive orthodontic treatment (IOT) can be of great benefit to some patients, it validates the need to assess the factors that influence the implementation of such treatment.

博士(工学) / Doctor of Philosophy in Engineering / 同志社大学 / Doshisha University

Introduction: Socioeconomically disadvantaged children have limited access to orthodontic services not only because of their families’ competing needs for limited resources, but also because of the limited availability of orthodontists in their communities and a shortage of orthodontists who are willing to treat patients enrolled in Medicaid. We will systematically explore the hypothesis that an early interceptive treatment protocol using removable appliances provides the same treatment outcome but better cost-effectiveness than a traditional fixed-appliance protocol. Methods: Interim data on a prospective study with patients being treated either in private practice with rational fixed Phase I orthodontic treatment (n=11) or in a community clinic with removable interceptive orthodontic treatment (n=10). Initial and post treatment study models were acquired along with pretreatment PAR and clinical photos. PAR and ICON scores were assessed on all initial and final casts. Cost effective analyses were performed comparing the two treatment groups as well as comparing the removable group to no treatment. Sensitivity analyses were performed to assess the robustness of our data while manipulating certain treatment outcome variables. Results: For the fixed group the average PAR score at T2 was 7.6 with a 68% reduction from T1 to T2, while the ICON average score was 16.2 with a 67% reduction. In the removable group the average PAR score at T2 was 13.4 with a lesser reduction from T1 to T2 than the fixed group at 48% (p=0.20), while the ICON average score was 25.3 with a significantly lower reduction of 39% when compare to the fixed group (p=0.037). Cost effectiveness analyses showed that the removable appliance treatment protocol was cost effective when compared to no treatment but not cost effective when compared to 3 the traditional fixed Phase I treatment using the studies measured probabilities of success. Conclusion: The removable appliance protocol used at the Fruitvale community clinic can effectively reduce the severity of malocclusions. However, in order for this treatment to be cost effective when compared to a traditional fixed Phase I protocol it needs to demonstrate consistent clinical results and minimize the probability of “No Improvement”.

IFMIF sera constitué de deux accélérateurs de deutons délivrant des faisceaux continus de 125mA et d’énergie 40MeV qui bombarderont une cible de lithium liquide. Face à cette très haute puissance faisceau de 10 MW, de nouveaux défis doivent être relevés pour le développement de tels accélérateurs. C’est pour cette raison qu’a été prise la décision de construire un accélérateur prototype, LIPAc (Linear IFMIF Prototype Accelerator) ayant les mêmes caractéristiques faisceau qu’IFMIF, mais avec une énergie limitée à 9MeV. Dans le cadre de cette thèse, des instruments de diagnostics faisceau ont été développés pour IFMIF et LIPAc. Ces diagnostics concernent des moniteurs de pertes faisceau ainsi que des profileurs transverse de faisceau travaillant en mode intercepteur ou non.Pour la surveillance des pertes faisceau, des chambres à ionisation et des détecteurs au diamant ont été testés et calibrés en neutrons et en γ dans la gamme en énergie de LIPAc. Lors de ces expériences, pour la première fois des diamants ont été testés avec succès à des températures cryogéniques. Pour les profileurs interceptant le faisceau, des simulations thermiques ont été réalisées afin d’assurer leur bon fonctionnement. Pour les profileurs n’interceptant pas le faisceau, des moniteurs basés sur l’ionisation du gaz résiduel (IPM) contenu dans le tube faisceau ont été développés. Un prototype a été construit et testé, puis s’inspirant de ce retour d’expérience les IPMs finals ont été conçus et construits. Pour contrecarrer la charge d’espace générée par le faisceau, un algorithme a été élaboré afin de reconstruire le profil réel du faisceau. / The IFMIF accelerator will accelerate two 125mA continuous wave (cw) deuteron beams up to 40MeV and blasts them onto a liquid lithium target to release neutrons. The very high beam power of 10MW pose unprecedented challenges for the accelerator development. Therefore, it was decided to build a prototype accelerator, the Linear IFMIF Prototype Accelerator (LIPAc), which has the very same beam characteristic, but is limited to 9 MeV only. In the frame of this thesis, diagnostics devices for IFMIF and LIPAc have been developed. The diagnostics devices consist of beam loss monitors and interceptive as well as non-interceptive profile monitors. For the beam loss monitoring system, ionization chambers and diamond detectors have been tested and calibrated for neutron and γ radiation in the energy range expected at LIPAc. During these tests, for the first time, diamond detectors were successfully operated at cryogenic temperatures. For the interceptive profilers, thermal simulations were performed to ensure safe operation. For the non-interceptive profiler, Ionization Profile Monitors (IPMs) were developed. A prototype has been built and tested, and based on the findings, the final IPMs were designed and built. To overcome the space charge of accelerator beam, a software algorithm was written to reconstruct the actual beam profile.

O presente estudo teve por objetivo a avaliação das consequências da expansão rápida da maxila em indivíduos com fissura labiopalatina unilateral nos seguintes desfechos: rizogênese, reabsorção radicular, espessura da tábua óssea e deiscência. Este estudo de coorte prospectivo foi composto por 30 participantes, sendo 20 homens e 10 mulheres, entre 8 e 15 anos. Os participantes foram alocados em 3 grupos, conforme o tipo de atresia maxilar, e tratados com diferentes tipos de aparelho expansor: G1, Hyrax; G2, Expansor em Leque; G3, Mini-Hyrax Invertido. Foram realizadas Tomografias Computadorizadas de Feixes Cônicos imediatamente antes do tratamento e 90 dias após contenção do aparelho. Medições lineares foram obtidas pelo mesmo examinador cegado. A estatística inferencial dos dados, após testes de normalidade e homogeneidade, foi realizada pela análise de regressão multinível. As raízes que apresentavam o ápice aberto ao início do tratamento demonstraram um aumento estatisticamente significante após o tratamento. Em contrapartida, não houve alterações significativas no comprimento radicular das raízes que apresentavam o ápice fechado no início do tratamento. Uma diminuição significativa da espessura da tábua óssea vestibular, bem como um aumento significativo da deiscência pode ser observado. Não houve diferença significante entre o lado com e sem a fissura para todas as variáveis apresentadas, assim como não houve diferença entre os grupos. Os achados neste estudo permitem concluir que as forças ortopédicas da expansão rápida da maxila não são capazes de interromper o processo de desenvolvimento radicular, tampouco causar reabsorção radicular apical externa significativa em indivíduos com fissura labiopalatina unilateral. Contudo, uma diminuição significativa de volume ósseo vestibular posterior é esperada, mas não deve ser considerada importante clinicamente. / The present study aimed to evaluate the consequences of rapid maxillary expansion in subjects with unilateral cleft lip and palate in the following outcomes: root formation, root resorption, buccal bone thickness and dehiscence. This prospective cohort study comprised 30 participants, 20 male and 10 female, between 8 and 15 years old. Participants were allocated in 3 groups, according to the type of maxillary constriction, and were treated with different types of expanders: G1, hyrax; G2, fan-type; G3, inverted mini-hyrax. Cone Beam Computed Tomography scans were performed immediately before treatment and after 90 days of retention. Linear measurements were obtained by the same blinded examiner. The inferential statistics of the data, after normality and equality tests, was performed with a multilevel regression analysis. The roots presenting open apexes at the beginning of treatment showed a statistically significant increase in length after treatment. On the other hand, there were no significant changes in the root length of roots that had a closed apexes at the beginning of the treatment. A significant decrease in buccal bone thickness as well as a significant increase in dehiscence were observed. There was no significant difference between the cleft and non-cleft side for all variables, as there was no significant difference between groups. The findings in this study allow to conclude that the orthopedic forces of rapid maxillary expansion are not able to interrupt the root development process nor to cause significant external apical root resorption in subjects with unilateral cleft lip and palate. However, a significant decrease in posterior buccal bone volume is expected, but it should not be considered important in a clinical perspective.

The IFMIF accelerator will accelerate two 125mA continuous wave (cw) deuteron beams up to 40MeV and blasts them onto a liquid lithium target to release neutrons. The very high beam power of 10MW pose unprecedented challenges for the accelerator development. Therefore, it was decided to build a prototype accelerator, the Linear IFMIF Prototype Accelerator (LIPAc), which has the very same beam characteristic, but is limited to 9 MeV only. In the frame of this thesis, diagnostics devices for IFMIF and LIPAc have been developed. The diagnostics devices consist of beam loss monitors and interceptive as well as non-interceptive profile monitors. For the beam loss monitoring system, ionization chambers and diamond detectors have been tested and calibrated for neutron and γ radiation in the energy range expected at LIPAc. During these tests, for the first time, diamond detectors were successfully operated at cryogenic temperatures. For the interceptive profilers, thermal simulations were performed to ensure safe operation. For the non-interceptive profiler, Ionization Profile Monitors (IPMs) were developed. A prototype has been built and tested, and based on the findings, the final IPMs were designed and built. To overcome the space charge of accelerator beam, a software algorithm was written to reconstruct the actual beam profile.

Magister Scientiae Dentium - MSc(Dent) (Community Oral Health) / The aim of this study was to establish whether there is any association between developing maxillary canine ectopia and various other dental anomalies using panoramic radiographs in the mixed dentition stage of development.

Orientador: Vania Celia Vieira de Siqueira / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-15T06:03:17Z (GMT). No. of bitstreams: 1 Sousa_MeireAlvesde_D.pdf: 1934280 bytes, checksum: 6ccaf4ca61a91707535d7c63a1d6cd46 (MD5) Previous issue date: 2010 / Resumo: A eletromiografia de superfície representa um importante instrumento de avaliação da função muscular. No entanto, apresenta limitações, devido à grande variabilidade que ocorre na amplitude do sinal eletromiográfico obtido. Com o intuito de diminuir essa variabilidade, sugere-se a normalização dos dados coletados, que consiste na divisão do sinal eletromiográfico bruto registrado por um valor de referência, expresso em porcentagem, derivado da própria medida do sinal eletromiográfico. Objetivou-se neste estudo avaliar, por meio da eletromiografia, a ocorrência de alterações na atividade eletromiográfica da porção superficial do músculo masséter, da porção anterior do músculo temporal e dos segmentos superior e inferior do músculo orbicular da boca, bilateralmente, em 25 jovens, entre 8 e 10 anos de idade, com maloclusão Classe II, 1ª divisão dentária, após se submeterem ao tratamento ortodôntico com o aparelho extrabucal, comparando-os com um grupo de 25 jovens com oclusão normal, com idade similar. Além de avaliar se o procedimento de normalização dos dados obtidos influencia no resultado final. Para a captação dos sinais eletromiográficos dos músculos masséter e temporal utilizou-se eletrodos de superfície ativos diferenciais simples, e para o músculo orbicular da boca, eletrodos de superfície passivos de Ag/AgCl. Realizou-se a coleta do sinal na situação de repouso, na contração isométrica e na contração isotônica, antes e após o tratamento ortodôntico no grupo com maloclusão e em períodos similares no grupo com oclusão normal. Por meio de software específico, determinou-se o valor da Root Mean Square (RMS) de cada movimento realizado. Submeteu-se os dados iniciais coletados à normalização, comparando-os com os dados iniciais originais, por meio da análise de variância (ANOVA) para parcelas subdivididas Os resultados demonstraram que o procedimento de normalização influenciou a interpretação dos dados ao suprimir as diferenças existentes entre os grupos, reforçando a idéia de que os resultados originais permitiram conclusões mais adequadas do que os dados normalizados. Com base nesses resultados, optou-se pela utilização dos dados originais para avaliar o efeito do tratamento ortodôntico no grupo com maloclusão. Nesta etapa utilizou-se a ANOVA para medidas repetidas com modelos mistos e o teste de Tukey (a=0,05). Observou-se que ocorreu uma diminuição na atividade eletromiográfica de todos os músculos do grupo com maloclusão e com oclusão normal, entretanto esta diferença não apresentou-se estatisticamente significante para o músculo temporal direito e orbicular da boca, segmento superior. Na fase inicial do estudo o grupo com maloclusão apresentou maior atividade elétrica em todos os músculos do que o com oclusão normal, no entanto, essa diferença não apresentou-se significante para o músculo masséter. Não ocorreram diferenças significativas entre os grupos na fase final do experimento. Concluiu-se que o tratamento com o aparelho extrabucal possibilitou a melhora do padrão muscular das jovens com maloclusão Classe II, 1ª divisão dentária. / Abstract: The surface electromyography is an excellent way to evaluate the muscle function. However, it presents limitations, because the great variability in the amplitude of the electromyographic signal obtained. To reduce this variability, has been proposed the normalization of the electromyographic signal. The process consist of dividing the raw electromyographic recorder signal by a reference value expressed as a percentage, derived from measure of the electromyographic signal itself. The purpose of this study was to evaluate electromyographically the action potential of the superficial masseter muscle, the anterior temporal muscle, the orbicularis oris muscle, upper and lower segment, bilaterally, in 25 young females, aged ranging from 8 to 10 years old, with Class II division 1 malocclusion after the treatment with extraoral appliances and to compare them with 25 young females with normal occlusion, with similar aged. And to evaluate if the experiment final results can be influenced by the normalization of electromyographic data. The electromyographic signals of the masseter and temporal muscles were adquired by active single differential surface electrodes, and of the orbicularis oris muscle by passive surface electrodes of the Ag/AgCl. Muscle activity was recorded in resting position, in isometric contraction and in isotonic contraction, before and after orthodontic treatment in the malocclusion group and similar periods in the normal occlusion group. Through of specific software was determined the Root Mean Square (RMS) values of each movement. The initial data collected were submitted to the normalization procedure and were compared with the initial raw data, through of statistical analyses of variance. The results showed that the normalization procedure was able to affect the electromyographic data, suppressing the difference between the groups. This support the idea that the raw data were able to produce better conclusions than normalized data. Thus, the orthodontic treatment of the malocclusion group was evaluated using the raw data, through of statistical analyses of variance and Tukey test (a=0,05). The results showed that there was decrease of the electromyographic activity in all the muscles, in both groups difference between the groups, but that difference was not statistically significant for the right temporal muscle and the orbicularis oris muscle upper segment The muscle activity was higher in the malocclusion group than normal occlusion group in the initial phase, but that difference was not statistically significant for the masseter muscle. In the final phase there was not significant difference between the groups. It was concluding that the treatment with extraoral appliances was able to improve the muscular pattern of the young females with Class II division 1 malocclusion. / Doutorado / Ortodontia / Doutor em Radiologia Odontológica

Thesis--University of Oklahoma. / Includes bibliographical references (leaves 99-101).