Microrganismos do gênero Candida estão presentes na saliva de aproximadamente metade da população e geralmente não causam doenças. Usuários de próteses totais removíveis apresentam aumento no número de Candida na saliva, o que contribui para o desenvolvimento de estomatite protética. Além de aderirem à resina acrílica, esses microrganismos são capazes de aderir à liga metálica de cobaltocromo de próteses parciais removíveis a grampo. O propósito deste trabalho foi relacionar a presença e o número de leveduras do gênero Candida na saliva não estimulada de usuários de prótese parcial removível a grampo com a proporção metal/resina acrílica presente nas próteses. Saliva de 40 usuários de prótese parcial removível a grampo e de 40 indivíduos não usuários de qualquer tipo de prótese removível foi coletada e semeada, e as unidades formadoras de colônia sugestivas de Candida foram contadas e identificadas. A proporção metal/resina acrílica de cada prótese foi medida utilizando-se placas de silicone prensadas sobre cada prótese. Os moldes de silicone foram pesados e, de acordo com o peso, a área foi calculada. Os resultados obtidos foram avaliados estatisticamente com nível de significância de 5%. Houve diferença estatística significativa entre os grupos teste e controle, para o número de unidades formadoras de colônia por mililitro (n de UFC/ml) de saliva e fraca correlação positiva entre área de metal e resina com n de UFC/ml encontrados no grupo-teste, todavia sem diferença estatística significativa. A espécie mais prevalente nas amostras estudadas tanto no grupo-teste quanto no grupo-controle foi Candida albicans. / Microorganisms of the Candida genus are present in the saliva of approximately half the population and generally do not cause diseases. Removable complete denture wearers present increased numbers of Candida in saliva, which contribute to the development of prosthetic stomatitis. In addition to adhering to acrylic resin, these microorganisms are capable of adhering to the cobalt-chrome metal alloy of clippedon removable partial dentures. The purpose of this study was to relate the presence and number of Candida genus yeasts in the not estimulated saliva of clipped-on removable partial dentures to the proportion of metal/acrylic resin present in the dentures. Saliva from forty clipped-on removable partial denture wearers and of forty non-wearers of any type of removable denture was collected, seeded, and the colony forming units suggestive of Candida counted and identified. The metal/acrylic resin proportion of each denture was measured, using silicone plates pressed over each denture. The silicone molds were weighed, and from the weight, the area was calculated. The results obtained were statistically assessed at a level of significance of 5%. There was statistically significant difference between the test and control groups for the number of colony forming units per milliliter (No. of CFU/ml) of saliva and weak positive correlation between the metal and resin area with the No. of CFU/ml found in the test group, however, without statistically significant difference. The most prevalent species in the studied samples, both in the test and control groups, was Candida albicans.

Les méthodes d’intégration de jauge, telle que l’intégrale de Pfeffer sur les ensembles bornés de périmètre fini sont particulièrement adaptées à l’étude des grands théorèmes d’intégration que sont le Théorème Fondamental de l’Analyse, le Théorème de la Divergence et le Théorème de Stokes. Dans cette thèse, ces outils sont transposés à l’intégration sur des domaines singuliers, vus comme des courants entiers au sens de Federer et Fleming. On obtient un critère d’effaçabilité pour les singularités des courants considérés : les courants ayant un ensemble singulier de contenu de Minkowski relatif fini satisfont un Théorème de Stokes général, c’est le cas notamment des courants définissables dans une structure o-minimale quelconque, c’est aussi le cas de courants minimiseurs de masse sans singularité au bord. A contrario, on construit un courant de dimension 2 dans ℝ3 ayant un ensemble singulier réduit à un point, qui ne vérifie pas ce Théorème de Stokes général.Cette thèse contient aussi les définitions de méthodes d’intégration non absolument convergentes sur tout courant entier de dimension 1, ainsi que sur les courants entiers de dimension quelconque dans un espace euclidien dont les singularités sont effaçables. / Methods of gauge integration, like those developped by W. F. Pfeffer on bounded sets of finite perimeter, are well suited to the study of integration theorems, such as the Fundamental Theorem of Calculus, The Divergence Theorem and Stokes’ Theorem. In this thesis, Pfeffer Integration is transposed to the context of integral currents in the sense of Federer and Fleming. Not all integral currents are adapted to this type of gauge integration and a criterion on the singular set of the current is obtained. Well behaved currents include all 1-dimensional integral currents, integral currents definable in an o-minimal structure and mass minimizing integral currents whenever the boundary singularities are controlled. All those currents are shown to satisfy a general Stokes’ Theorem. On the other hand, an example is given of an integral current of dimension 2 in ℝ3 with only one singular point, which does not satisfy such a general Stokes-Cartan Theorem. This thesis also contains the definitions of non-absolutely convergent integrations methods on 1-dimensionalintegral currents as well as on integral currents of any dimension in Euclidean space, whenever their singular set has controlled relative Minkowski content.

京都大学 / 0048 / 新制・課程博士 / 博士(工学) / 甲第18232号 / 工博第3824号 / 新制||工||1586(附属図書館) / 31090 / 京都大学大学院工学研究科合成・生物化学専攻 / (主査)教授 杉野目 道紀, 教授 吉田 潤一, 教授 村上 正浩 / 学位規則第4条第1項該当 / Doctor of Philosophy (Engineering) / Kyoto University / DFAM

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Introduction: Orthodontic and orthopedic expansion is necessary to create space to resolve crowding due to arch deficiency or tooth size discrepancy. The Invisalign First clear aligner appliance as a modality for early interceptive orthodontic treatment has become incorporated into orthodontic practices in very recent years. The present study aims to investigate the magnitude of expansion of the Invisalign First clear aligner appliance compared to a Schwartz removable expander in patients with mixed dentition. Additionally, the study aims to compare the efficacy and predictability of Invisalign First clear aligners in this population. Materials & Methods: In this retrospective study, a sample was collected from a single orthodontist practitioner. The sample consisted of 34 patients, 16 patients treated with Invisalign First clear aligners only (Group1) and 19 patients treated with a Schwartz removable appliance and Invisalign First clear aligners (Group 2). Intraoral scans of four timepoints, initial (T1), post-expansion for Group 2 only (T1Exp), first refinement (T2), and final (T3), and planned Clincheck goal (P) model from Clincheck software were imported to Align Technology’s digital measure program (Quantify©). Arch widths and molar inclinations were measured at each timepoint and the changes between timepoints were calculated. Predictability of arch expansion was calculated as T13 (change between initial and final) divided by the Planned dimension multiplied by one hundred. A two sample t-test was used to assess differences in the changes in arch widths and predictability of expansion between two groups. Results: There were statistically significant differences found in the magnitude of expansion and predictability of arch expansion between two groups. Group 2 showed a greater amount of expansion and predictability. Group 1 showed about 50-60% of the planned expansion at the end of treatment. In regards to magnitude of expansion when comparing the two groups, the efficacy predictability of transverse dimensional changes were significantly greater in the Group 2 compared to Group 1, 83% vs 56% (p = 0.001), respectively. The changes in inclination were similar in both groups, with no statistically significant differences.Conclusions: There is a significantly greater amount of expansion and greater predictability with the Schwartz removable appliance compared to the Invisalign First clear aligner appliance in the mixed dentition. The predictability of Invisalign First was 56% and indicates a significant overcorrection of arch expansion is required at the virtual treatment planning stage in Clincheck in order to obtain the arch expansion that was planned

The aim of this thesis is to describe the development of oral health and possible associations with socioeconomic and socio-behavioural factors, in an adult population over a period of 30 years. A further aim is to describe attitudes to, and demands of dental care, and the impact of oral conditions on quality of life. The study sample consisted of 787-1158 individuals, aged between 35-85 years, randomly selected from Dalarna’s population register in 1982, 2002, 2007 and 2012. The studies were carried out in 1983, 2003, 2008 and 2013, and the participants responded to a questionnaire and a clinical examination of oral status. There has been a substantial improvement in oral status in regard to the mean number of teeth, intact teeth, and less removable dentures over this period of 30 years. The proportion of individuals with alveolar bone loss decreased significantly between 1983 and 2008, but increased significantly between 2008 and 2013. Smoking was the overall strongest factor associated with alveolar bone loss, after adjustment for socioeconomic and socio-behaviour factors, age and number of teeth. Calculus, visible on radiographs, increased significantly between 2003 and 2013. The proportion of individuals with manifest caries declined significantly between 1983 and 2008, but seems to level out between 2008 and 2013. Socioeconomic and socio-behaviour factors were significantly associated with manifest caries. Preventive treatment, meeting the same caregiver as on previous visits, and information about treatment cost was reported to a significantly lower degree as important in 2013, compared with 2003 and 2008, and booking time for treatment was reported as more difficult in 2013, compared with earlier years. Regular recalls was reported as less important in 2013, compared with 2008. A third of the respondents reported oral impact on daily performance and irregular dental visits, limited economy for dental care, less than 20 remaining teeth, manifest caries and temporomandibular disorder were significantly associated with oral impact on daily performance.

Os objetivos desse estudo foram comparar a condição periodontal de dentes pilares e não pilares dos indivíduos reabilitados com prótese parcial removível e avaliar o impacto na qualidade de vida de indivíduos parcialmente endêntulos, após o uso da PPR. As comparações entre os dois grupos para medidas quantitativas foram feitas através do teste não paramétrico de Wilcoxon, pois os dados não tiveram distribuição normal. Para medidas qualitativas foi utilizado o teste de Wilcoxon. Em todos os testes foi adotado nível de significância de 5%. Foram avaliados 113 dentes pilares de e 122 dentes não pilares. Dos dentes não pilares, 49 se localizavam em maxila e 73 em mandíbula. Dos dentes pilares, 61 se localizava em maxila e 52 em mandíbula. Os parâmetros avaliados foram profundidade de sondagem, nível de inserção clínica, índice gengival, índice de placa, recessão gengival, condições de higiene da prótese, quantidade de mucosa ceratinizada, classificação da área desdentada segundo Kennedy, tipo de grampo utilizado, influência da condição oral na qualidade de vida. A média de uso da PPR em dentes não pilares foi de 6,25 anos com desvio padrão de 3,592. A média de uso de PPR em dentes pilares foi de 7,15 anos com desvio padrão de 3,869. Em todas as médias de profundidade de sondagem os dentes pilares apresentaram maior resultado, mostrando diferenças estatisticamente significantes. Em todas as médias de nível de inserção clínica os dentes pilares apresentaram maior resultado e diferenças estatisticamente significantes. Resultados quanto ao índice gengival não mostram diferenças estatísticas. Dentes pilares apresentam uma maior incidência em scores mais altos do índice de placa, mas não foi encontrada diferença estatisticamente significante. A quantidade de mucosa ceratinizada para dentes não pilares, medida em mm, foi em média 2,70, com desvio padrão de 1,271. A quantidade de mucosa ceratinizada para dentes pilares, medida em mm, foi em média 2,66, com desvio padrão de 1,207. Resultados quanto a quantidade de mucosa queratinizada não mostram diferenças estatísticas. Dentes pilares mostram menor incidência de dentes sem recessão e maior incidência de dentes com recessões, porém não se encontrou diferenças estatísticas. As médias de profundidade de sondagem e nível de inserção clínica dos dentes pilares em relação aos tipos de grampos foram maiores com grampos de ação abraçamento. Próteses instaladas em arcos do tipo I mostraram maior índice de Tarbet. O impacto do uso de PPR na qualidade de vida foi fraco. A comparação dos parâmetros clínicos dos dentes pilares e não pilares mostrou diferenças estatísticas apenas para os parâmetros clínicos de profundidade de sondagem e nível de inserção clínica; as médias de profundidade de sondagem e nível de inserção clínica dos dentes pilares em relação aos tipos de grampos foram maiores com grampos de ação abraçamento; próteses instaladas em arcos do tipo I mostraram maior índice de Tarbet; impacto na qualidade de vida da prótese parcial removível foi fraco. / The aim of this study was compare the periodontal condition of abutment and nonabutment teeth of individuals rehabilitated with removable partial denture and evaluate the impact on quality of life of individuals after using the RPD. The comparisons between the two groups for quantitative measurements were made using the Wilcoxon nonparametric test, since the data were not normally distributed. For qualitative measures the Wilcoxon\'s test was used. For all tests the significance level of 5% was used. It were evaluated 113 abutment teeth of RPD and 122 non-abutment teeth. 61 abutment teeth were maxillary and 52 were mandibular; 49 non-abutment teeth were maxillary and 73 were mandibular. The parameters evaluated were probing depth, clinical attachment level, gingival index, plaque index, gingival recession, hygiene conditions, quantity of keratinized mucosa, classification according to Kennedy, type of clasp used, influence of oral condition on quality of life. The average use of RDP of non-abutment teeth was 6,25 years with SD of 3,592. The average use of RDP of abutment teeth was 7,15 years with SD of 3,869. Abutment teeth had higher averages of probing depth and clinical attachment level, showing statistically significant differences. Gingival index and plaque index did not show differences between groups. The average quantity of keratinized mucosa for non-abutment teeth, in mm, were 2,70 with SD 1,271. The average quantity of keratinized mucosa for abutment teeth, in mm, were 2,66 with SD 1,207. It didt have significant differences. Abutment teeth had higher incidence of gingival recession, but it wasnt significant differences. RPD did not influence the quality of life. There was no statistically significant difference between the abutment teeth and not-abutment teeth except for probing depth and clinical the attachment level. Prothesis of Class I of Kennedy had higher levels of Tarbet index. RPD had no influence in quality of life.

A tecnologia CAD-CAM vem sendo aplicada há mais de uma década para a confecção de trabalhos protéticos odontológicos e bucomaxilofaciais. A tecnologia de prototipagem rápida permite a construção de um modelo em tempo reduzido por meio do sistema CAD (computer-aided design) e CAM (computer-aided manufacturing), permitindo absoluta fidelidade ou discrepância desprezível. Assim, o objetivo deste trabalho será analisar a viabilidade da aplicação da tecnologia CAD-CAM por prototipagem rápida na confecção de estrutura metálica da prótese parcial removível, comparando-a ao método convencional. O projeto visa à obtenção de melhores benefícios funcionais e econômicos aos pacientes, trazendo à luz inovações tecnológicas, novos conceitos e melhores condições para o restabelecimento da saúde bucal. A metodologia empregada partiu da reprodução de um modelo padrão de uma arcada inferior parcialmente desdentada, classe III Mod-1 de Kennedy. Quatro pilares metálicos foram posicionados no local dos primeiros pré-molares e molares. Com o auxílio de um scanner digital 3D, obteve-se um modelo virtual da arcada, no qual foi modelado digitalmente o desenho da estrutura protética. Oito estruturas de PPR foram confeccionadas utilizando-se a tecnologia de prototipagem rápida e, posteriormente fundidas em liga de cobalto-cromo. Outras oito estruturas foram confeccionadas seguindo o protocolo para confecção de PPR de forma convencional. A análise comparativa foi realizada avaliando o peso perdido. A avaliação por peso está dividida em dois grupos. O primeiro, denominado Grupo AP (Ajuste e Polimento), possui quatro estruturas convencionais (Grupo AP-C) e quatro prototipadas (Grupo AP-P). O segundo, chamado Grupo A (Ajuste) realizado somente ajuste sem polimento, com quatro estruturas convencionais (Grupo A-C) e quatro prototipadas (Grupo A-P). Análise comparativa por peso mensurou a porcentagem de material perdido necessário para o adequado assentamento dos apoios das estruturas metálicas pela técnica convencional e por prototipagem em seus respectivos descansos. Os resultados mostraram que as estruturas foram passíveis de serem obtidas pela tecnologia proposta. A análise comparativa mostrou que o Grupo AP-P apresentou um desgaste médio de 0,9826g, correspondente a 13,5188% de seu peso inicial; o Grupo AP-C apresentou um desgaste médio de 0,7529g, correspondente a 12,4380% de seu peso inicial. A análise por meio de Teste t independente mostrou uma diferença estatisticamente significante com valor de p=0,0386, p<0,05. No Grupo A-P houve um desgaste médio de 0,1045g, correspondente a 1,4455% de seu peso inicial. No Grupo A-C houve um desgaste médio de 0,1473g, correspondente a 2,3188% de seu peso inicial. A análise por meio de Teste t independente mostrou uma diferença estatisticamente significante com valor de p=0,0038, p<0,01. Foi viável a aplicação da tecnologia CAD-CAM por prototipagem rápida na confecção de estrutura metálica da prótese parcial removível. / The CAD-CAM technology has been applied for more than a decade for the manufacturing of dental and maxillofacial prosthesis. The rapid prototyping technology allows for the construction of a model in reduced time by using the CAD (computer-aided design) and CAM (computer-aided manufacturing) systems, allowing absolute preciseness or negligible discrepancies. Thus, the purpose of this research is to analyze the viability of the application of the CAD-CAM technology of rapid prototyping in the manufacturing of removable partial dentures(RPD) compared to the conventional method. The purpose of this research was to obtain functional and financial benefits for the patient, demonstrate recent technological advances and concepts and improve the resources for the reestablishment of oral health. The methodology used to determine effectiveness of the CAD-CAM system started with the reproduction of a Kennedy Class III Modification 1 cast of an inferior partially edentulous dental arch,. Four metallic pins were positioned in place of the first premolars and molars. A 3D scanner was used to construct a virtual model of the arch on which the design of the prosthetic structure was digitally formed. Eight RPD frameworks were manufactured using the fast prototyping technology with subsequent casting with a cobalt-chromium alloy; eight others followed the standard RPD waxing/casting procedure. The analysis between procedures evaluated the weight lost when each of the respective frameworks were processing. The results were divided into two groups. The first group, named AP (Adjusted and Polished), had four standard (Group AP-C) and four prototyped (Group AP-P) frameworks. The second group, named A (Adjusted), also includes eight frameworks (four standard, Group A-C, and four prototyped, Group A-P) which were cast and adjustted but not polished. In the comparative analysis, the variation of the weight determined the percentage of the material lost needed for the adequate settling of the rests in their respective seat with the standard and prototyped methods. The data indicated that frameworks can be obtained with the proposed technology. The comparative analysis results showed an average wear of 0.9826g on Group AP-P, corresponding to 13.5188% of its initial weight. In the Group AP-C, average wear was 0.7529g, 12.4380% of its initial weight. With the independent t-test, a significant statistical difference of p=0.0386, p<0.05 was found. The average wear for Group A-P wasf 0,1045g, 1.4455% of its initial weight, while in Group A-C the value was 0.1473g, corresponding to 2.3188% of its initial weight. The independent t-test analysis for these cases shows a significant statistical difference of p=0.0038, p<0.01. The application of the CAD-CAM technology of fast prototyping is viable for the manufacturing of removable partial dentures.

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

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