Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal.

O presente estudo tem o objetivo de verificar os efeitos das cirurgias primárias sobre os arcos dentários de crianças com fissura completa de lábio e palato unilateral submetidas a dois diferentes protocolos cirúrgicos, Spina + Von Langenbeck (Grupo 1) e Millard + Von Langenbeck (Grupo 2), considerando também a presença ou ausência de bandeleta de Simonart. Para a avaliação da relação interarcos foi utilizado o Índice de Atack em uma amostra de 145 modelos de gesso obtidos aos 5 a 6 anos de idade. Nos resultados relativos aos protocolos cirúrgicos a comparação dos escores agrupados demonstrou maior ocorrência de índices 4 e 5 (42%) para ambos os grupos, com índices oclusais médios de 3,22 para o Grupo 1 e 3,12 para o Grupo 2. Houve maior prevalência de índices 4 e 5 tanto para os pacientes com bandeleta (53%) como sem bandeleta (39%), que apresentaram índices oclusais médios de 3,41 e 3,11, respectivamente. A avaliação individual do protocolo cirúrgico Spina + Von Langenbeck, considerando a presença de bandeleta, demonstrou maior porcentagem de índice 3, para os pacientes com bandeleta (42%) e índices 4 e 5 para os sem bandeleta (44%), com índices oclusais médios de 3,0 e 3,27, respectivamente. Para o protocolo de Millard + Von Langenbeck, o grupo com bandeleta apresentou acentuada maioria de índices 4 e 5 (76%) enquanto que no grupo sem bandeleta prevaleceu índices 1 e 2 (50%), com índices oclusais médios de 3,88 e 2,71, respectivamente, com diferença estatisticamente significativa entre eles (p=0,001). Na amostra estudada a avaliação dos protocolos cirúrgicos e da presença de bandeleta, de acordo com os valores dos índices oclusais, demonstrou que a maioria dos casos apresentou uma pobre relação entre os arcos, com prognóstico de tratamento ortodôntico-cirúrgico. / This study analyzed the effects of primary surgeries on the dental arches of children with complete unilateral cleft lip and palate submitted to two different surgical protocols, Spina + Von Langenbeck (Group 1) and Millard + Von Langenbeck (Group 2), also considering the presence or absence of a Simonarts band. The interarch relationship was assessed by the Atack index on a sample of 145 dental casts obtained at 5 to 6 years of age. In results related to the surgical protocols, the comparison of grouped scores revealed higher occurrence of scores 4 and 5 (42%) for both groups, with mean occlusal scores of 3.22 for Group 1 and 3.12 for Group 2. There was higher prevalence of scores 4 and 5 both for patients with band (53%) and without band (39%), who presented mean occlusal scores of 3.41 and 3.11, respectively. Individual analysis of the surgical protocol Spina + Von Langenbeck, considering the presence of a Simonarts band, demonstrated higher percentage of score 3 for patients with band (42%) and scores 4 and 5 for patients without band (44%), with mean occlusal scores of 3.0 and 3.27, respectively. Concerning the protocol Millard + Von Langenbeck, the group with band exhibited great majority of scores 4 and 5 (76%), while the group without band had predominance of scores 1 and 2 (50%), with mean occlusal scores of 3.88 and 2.71, respectively, with statistically significant difference between them (p=0.001). In the present study sample, evaluation of the surgical protocols and presence of a Simonarts band according to the values of occlusal scores demonstrated that most cases presented poor interarch relationship, thereby with prognosis for orthodontic-surgical treatment.

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal

O presente estudo tem o objetivo de verificar os efeitos das cirurgias primárias sobre os arcos dentários de crianças com fissura completa de lábio e palato unilateral submetidas a dois diferentes protocolos cirúrgicos, Spina + Von Langenbeck (Grupo 1) e Millard + Von Langenbeck (Grupo 2), considerando também a presença ou ausência de bandeleta de Simonart. Para a avaliação da relação interarcos foi utilizado o Índice de Atack em uma amostra de 145 modelos de gesso obtidos aos 5 a 6 anos de idade. Nos resultados relativos aos protocolos cirúrgicos a comparação dos escores agrupados demonstrou maior ocorrência de índices 4 e 5 (42%) para ambos os grupos, com índices oclusais médios de 3,22 para o Grupo 1 e 3,12 para o Grupo 2. Houve maior prevalência de índices 4 e 5 tanto para os pacientes com bandeleta (53%) como sem bandeleta (39%), que apresentaram índices oclusais médios de 3,41 e 3,11, respectivamente. A avaliação individual do protocolo cirúrgico Spina + Von Langenbeck, considerando a presença de bandeleta, demonstrou maior porcentagem de índice 3, para os pacientes com bandeleta (42%) e índices 4 e 5 para os sem bandeleta (44%), com índices oclusais médios de 3,0 e 3,27, respectivamente. Para o protocolo de Millard + Von Langenbeck, o grupo com bandeleta apresentou acentuada maioria de índices 4 e 5 (76%) enquanto que no grupo sem bandeleta prevaleceu índices 1 e 2 (50%), com índices oclusais médios de 3,88 e 2,71, respectivamente, com diferença estatisticamente significativa entre eles (p=0,001). Na amostra estudada a avaliação dos protocolos cirúrgicos e da presença de bandeleta, de acordo com os valores dos índices oclusais, demonstrou que a maioria dos casos apresentou uma pobre relação entre os arcos, com prognóstico de tratamento ortodôntico-cirúrgico. / This study analyzed the effects of primary surgeries on the dental arches of children with complete unilateral cleft lip and palate submitted to two different surgical protocols, Spina + Von Langenbeck (Group 1) and Millard + Von Langenbeck (Group 2), also considering the presence or absence of a Simonarts band. The interarch relationship was assessed by the Atack index on a sample of 145 dental casts obtained at 5 to 6 years of age. In results related to the surgical protocols, the comparison of grouped scores revealed higher occurrence of scores 4 and 5 (42%) for both groups, with mean occlusal scores of 3.22 for Group 1 and 3.12 for Group 2. There was higher prevalence of scores 4 and 5 both for patients with band (53%) and without band (39%), who presented mean occlusal scores of 3.41 and 3.11, respectively. Individual analysis of the surgical protocol Spina + Von Langenbeck, considering the presence of a Simonarts band, demonstrated higher percentage of score 3 for patients with band (42%) and scores 4 and 5 for patients without band (44%), with mean occlusal scores of 3.0 and 3.27, respectively. Concerning the protocol Millard + Von Langenbeck, the group with band exhibited great majority of scores 4 and 5 (76%), while the group without band had predominance of scores 1 and 2 (50%), with mean occlusal scores of 3.88 and 2.71, respectively, with statistically significant difference between them (p=0.001). In the present study sample, evaluation of the surgical protocols and presence of a Simonarts band according to the values of occlusal scores demonstrated that most cases presented poor interarch relationship, thereby with prognosis for orthodontic-surgical treatment.

Objective: To determine the prevalence and odds ratios for cleft lip and/or palate (CL/P) among infants prenatally exposed to opioids with or without neonatal opioid withdrawal syndrome (NOWS). Design: This study represents an exploratory, retrospective cohort study design of newborn medical health records from 2011 to 2016. Setting: Records were drawn from a regional health system located in South Central Appalachia. Population and Study Sample: The original population yielded 3 cohorts of infants: (1) infants with opioid exposure (OE) but not requiring pharmacological intervention (OE; N = 168); (2) infants with NOWS requiring pharmacological intervention (N = 294); and (3) infants with no opioid exposure (NOE; N = 16 090), the primary comparison group. Main Outcome: Infants in the NOWS and OE groups showed significantly increased prevalence and odds ratios for CL/P when compared to those in the NOE group. Results: Prevalence rates per 1000 live births for infants with OE (35.71) and infants with NOWS (6.80) were significantly higher than those for infants with NOE (1.37). Comparison of infants with OE to the NOE group revealed significantly increased odds for CL/P, isolated cleft palate (CP), cleft lip (CL), and cleft lip and palate (CLP) (27.05, 41.81, 19.26, 19.37, respectively; all Ps <.008). The odds ratios for infants with NOWS compared to the NOE group were significantly higher for CL/P and CP (5.00 and 10.98, respectively; Ps <.03) but not for CL and CLP. Conclusion: The results provide additional evidence that prenatal OE should be considered among the critical environmental risk factors that can contribute to CL/P.

published_or_final_version / Dentistry / Master / Master of Dental Surgery

Made available in DSpace on 2016-01-26T12:51:31Z (GMT). No. of bitstreams: 1 eliasnaimkassis_tese.pdf: 1206838 bytes, checksum: 890b2f6915170e129c35065467aeb0f2 (MD5) Previous issue date: 2011-02-11 / The ingestion of alcohol by a mother during lactation changes the composition of the milk, resulting in the origin of ethanol and acetaldehyde in the milk, and turns more severe the effects of the ethanol in infant rats. Objective: This work aimed to study the effects of ethanol at the palatine bone and palatine epithelium of young infants in 21 days of postnatal life, administered to the experimental rats during lactation. Materials and Methods: The experimental rats received ethanol at 20% in the drinking fountain ad libitum during those 21 day of nursing. Another group of animals received an amount of water similar to that group without ethanol. The infant rats were put to death with an extra dose of anesthesia in their 21 days of life. Their heads were separated from their body, put in 85mls of a 80% alcohol solution, 10 ml of formalin and 5ml of acetic acid, the palate area was cut in serial sections by frontal plans, in the same level were the molar are located, the cuts were about 6 micrometers and were treated with hematoxylin-eosin. The nuclear parameters of the palate epithelium, the cytoplasmatic volume and cellular, the relation nucleon/cytoplasm, numerical density and superficial, the thickness of the epithelium were all estimate. The average body weight of the infant rats in the ethanol group was 20,20 g and the other group average weight was 34,86gr. Histologically, the palate epithelium was thinner and it had more numbers of smaller cells with a bigger nucleon. The palate bone had more delicate and less trabeculo calcificated, and smaller osteocyte. Conclusion: In this experiment, the ethanol induced a epithelial hypotrophy condition and palate bone more delicate and less calcificated, showing a direct affect in the cells and trabeculo palate and also the poor development of the intoxicated infant rats. / A ingestão materna de etanol durante a lactação altera a composição do leite, resulta no aparecimento do etanol e acetaldeído no leite, e exacerba os efeitos do etanol nos filhotes da rata. Objetivo: Este trabalho teve o objetivo de estudar os efeitos do etanol, ao epitélio palatino e osso palatino de filhotes lactantes em 21 dias de vida pós-natal, administrados nas ratas-mães durante a lactação. Materiais e Métodos: Para tal, foram utilizadas ratas que receberam etanol a 20% no bebedouro ad libitum durante os 21 dias de lactação. Os animais controles receberam um volume similar de água sem álcool. Os filhotes foram sacrificados com sobre dosagem anestésica no 21º dia. As cabeças foram separadas, fixadas em solução fixadora de álcool 80%- 85ml, formalina- 10 ml e ácido acético- 5ml, a região palatina foi seccionada seriadamente em planos frontais, ao nível dos molares, e os cortes de 6 micrometros foram tratados com hematoxilina-eosina . Os parâmetros nucleares do epitélio palatino foram estimados, assim como os volumes citoplasmáticos e celulares, relação núcleo/citoplasma, densidades numérica e superficial, e espessura epitelial. O peso corporal médio do filhote foi de 34,86 g no grupo controle e 20,20 g no tratado. Histologicamente, o epitélio palatino mostrou-se mais adelgaçado, constituído de células abundantes e menores com núcleos maiores. O osso palatino mostrou trabéculas mais delicadas e menos calcificadas e com osteócitos de menor tamanho. Conclusões: Neste experimento, o etanol, induziu no quadro de hipotrofia epitelial e osso palatino mais delicado e pouco calcificado, indicando uma ação direta nas células e trabéculas do palato, além de retardar o desenvolvimento de filhotes intoxicados.

The diploma thesis deals with the differences in the development of the palate in girls and boys within five age groups in the age range of 7 to 19 years, using methods of geometric morphometry. Furthermore, the work deals with the monitoring of sexual dimorphism in the development of the palate. Understanding palate growth, knowledge of differences in its development and changes related to sexual dimorphism are very useful, as the results of this study will serve as a comparative standard for palate defects in the Czech population, but also for appropriate planning of orthodontic procedures. The material consists of 228 gypsum castings of palate without any pathologies, 112 of which belonged to boys and 116 girls of the Czech population. Thus, transverse data are used in our study. The subjects were divided into five age groups 7, 10, 12, 15 and 19 with respect to gender. Age changes of the entire palate surface were modeled using geometric morphometry methods (Coherent point drift - Dense correspondence analysis, Per vertex T- test and Principal component analysis). To visualize the results, superprojection color maps, maps of significance and superprojection. The results show the greatest variability in the form of palate in girls of groups 10 and 12 years and in boys of groups 10 years, and...

Doctor Educationis / This study was a cephalometric and dental investigation of the treatment outcomes of UCLP children treated at the Red Cross Children's Hospital (RCCH) with respect to craniofacial morphology and dental arch relationship. The quality of the outcome for the RCCH group was compared with the outcomes reported for the Six-Centre International Study (Melsted et al., 1992; Mars et al., 1992). The sample consisted of 20 (11 females, 9 males) consecutively treated UCLP children who had cephalometric and dental records taken between the ages of8 to 11years (mean 10.13 ± 1.2 years). The cephalometric analysis described by Melsted et al. (1992) was used to evaluate the skeletal and soft tissue morphology. The quality of the dental arch relationship was measured according to the Gosion Yardstick (Mars et al., 1987). The treatment outcome of children treated at the RCCH was evaluated with respect to craniofacial form and dental arch relationship. When comparing the mean cephalometric skeletal parameters of the RCCH to the six centres in the Eurocleft study, a significant difference was found between the RCCH group and centre D for most of the variables. A significant increase in the upper incisor inclination and maxillary inclination was found in the RCCH patients compared to the European centres. The difference in the soft tissue parameters was limited to the relative protrusion of the nose and the sagittal soft tissue variable sss-ns-pgs. The analysis of the Goslon scores showed a significant difference between the RCCH group and centres C, D, and F. According to the Goslon score, 85% of the RCCH patients had good to satisfactory dental arch relationship, which was comparable to that recorded for centres A(92%), B(89%) and C(94). In conclusion, the results of the cephalometric analysis and the Goslon Yardstick showed a significant difference between the RCCH group and centre D. The GosIon score indicated good quality of the dental arch relationship, which faired favourably with the better centres in the Six Centre Study.

Objective: To determine the prevalence and odds ratios for cleft lip and/or palate (CL/P) among infants prenatally exposed to opioids with or without neonatal opioid withdrawal syndrome (NOWS). Design: This study represents an exploratory, retrospective cohort study design of newborn medical health records from 2011 to 2016. Setting: Records were drawn from a regional health system located in South Central Appalachia. Population and study sample: The original population yielded 3 cohorts of infants: (1) infants with opioid exposure (OE) but not requiring pharmacological intervention (OE; N = 168); (2) infants with NOWS requiring pharmacological intervention (N = 294); and (3) infants with no opioid exposure (NOE; N = 16 090), the primary comparison group. Main outcome: Infants in the NOWS and OE groups showed significantly increased prevalence and odds ratios for CL/P when compared to those in the NOE group. Results: Prevalence rates per 1000 live births for infants with OE (35.71) and infants with NOWS (6.80) were significantly higher than those for infants with NOE (1.37). Comparison of infants with OE to the NOE group revealed significantly increased odds for CL/P, isolated cleft palate (CP), cleft lip (CL), and cleft lip and palate (CLP) (27.05, 41.81, 19.26, 19.37, respectively; all Ps < .008). The odds ratios for infants with NOWS compared to the NOE group were significantly higher for CL/P and CP (5.00 and 10.98, respectively; Ps < .03) but not for CL and CLP. Conclusion: The results provide additional evidence that prenatal OE should be considered among the critical environmental risk factors that can contribute to CL/P.