Thesis (M.S.)--Universirt of Michigan, 1996. / Includes bibliographical references.

Thesis (M.S.)--University of Louisville, 1997. / eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

Thesis (M.S.)--University of Michigan, 2004. / Includes bibliographical references.

Thesis (Ph. D.)--University of Maryland, 1996. / Includes bibliographical references.

Thesis (M.S.)--University of Michigan, 2002. / Includes bibliographical references.

Thesis (M.S.)--University of Michigan, 2001. / Includes bibliographical references.

Thesis (Ph. D.)--University of Alabama at Birmingham, School of Joint Health Sciences, 1997. / Includes bibliographical references.

Thesis (M.S.)--University of Louisville, 1997. / Includes bibliographical references.

Reduction of oral health disparities is a worldwide goal because oral health has been shown to mimic individual and community health overall. At the end of the twentieth century, oral health made remarkable achievements; however, problems still remain in many communities around the world, especially within third world countries, such as those in South Asia. Member countries of the South-East Asia region of the World Health Organization (WHO) have stated that dental caries, tooth loss, periodontal disease, and oral cancer are some of the contending public health issues in their countries and action must be taken to reduce their numbers (WHO, 2008). The goals of this study are to determine what cultural aspects of the South Asian population aid in the increase of poor dental care in these communities. Our overall goal is to provide recommendations for a new oral health promotion program in South Asia that has been determined by understanding what cultural aspects are important in creating a successful dental care community program. As seen by the various studies, smokeless tobacco is a cultural norm in South Asia and is affecting the quality of life for many of the people there. Tobacco use is common but smokeless tobacco is becoming more prevalent in these countries. It is clear that with such statistics there is a need for governmental public programs to educate the population on the importance of proper oral care. This study analyzed the current literature to determine (i) what were the cultural aspects of South Asia that are detrimental to oral health, (ii) what is the oral health status of the individual countries found in South Asia, and lastly (iii) what aspects are necessary in creating an effective oral health program. The goal of this study is to determine what cultural aspects of the South Asian population contribute to poor dental care in these communities and to provide recommendations for a new oral health promotion program in South Asia that is strengthened by understanding what cultural aspects are important in creating a successful dental care community program. The conclusions presented here suggest an oral policy framework for the initiation of discussions aimed at designing and implementing an oral health program in their South-Asian country. Additionally, we suggest future directions once the guidelines are met. Overall, proper oral health should be enjoyed by all and this study aims to the aid the South Asian region’s governments towards moving forward in meeting those goals.

Submitted by VICTOR GUSTAVO BALERA BRITO (victor_balera@hotmail.com) on 2018-07-03T00:06:47Z No. of bitstreams: 1 Dissertação Mestrado (Victor G B Brito) (FINAL).pdf: 4446716 bytes, checksum: 348cbec88d5fb2161f9d4aaa27992ac2 (MD5) / Approved for entry into archive by Ana Paula Rimoli de Oliveira null (anapaula@foa.unesp.br) on 2018-07-03T12:24:17Z (GMT) No. of bitstreams: 1 brito_vgb_me_araca_int.pdf: 4446716 bytes, checksum: 348cbec88d5fb2161f9d4aaa27992ac2 (MD5) / Made available in DSpace on 2018-07-03T12:24:17Z (GMT). No. of bitstreams: 1 brito_vgb_me_araca_int.pdf: 4446716 bytes, checksum: 348cbec88d5fb2161f9d4aaa27992ac2 (MD5) Previous issue date: 2018-06-13 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / Introdução: A doença periodontal (DP) é uma desordem inflamatória dos tecidos de suporte dos dente, iniciada pelo acumulo de biofilme bacteriano, apresentando consequências locais e sistêmicas. A coexistência de doenças sistêmicas, como a hipertensão, pode levar a uma inflamação exacerbada, maior reabsorção óssea e dano sistêmico pronunciado. Além disso, células imunes residentes têm importante papel na progressão da DP, porém, a participação dos mastócitos (MC) ainda não é bem compreendida. Objetivos: Avaliar o papel dos MC sobre o metabolismo ósseo local (mandíbula) e sistêmico (fêmur), em modelo animal normotenso (ratos Wistar) e hipertenso (ratos SHR) com DP. Métodos: Ratos machos Wistar e SHR (10 semanas) foram utilizados. A depleção de MC foi conduzida pelo pré-tratamento com o composto 48/80 e a DP foi induzida por ligadura bilateral nos primeiros molares inferiores, mantida por 15 dias. Foi realizada a identificação de MC no tecido gengival, por coloração com Azul de Toluidina. A perda óssea alveolar e parâmetros de arquitetura óssea na mandíbula e fêmur foram avaliados por microtomografia computadorizada, a expressão gênica de marcadores de formação, remodelamento e reabsorção na mandíbula e fêmur foram avaliada por RT-PCR em tempo real, e a produção de citocinas nos tecidos de interesse foi avaliada por ELISA. Principais resultados: Observamos significativa perda óssea induzida por DP, principalmente no SHR, em comparação ao Wistar, e a depleção de MC foi capaz de prevenir esta perda. A DP levou a expressão aumentada de Opn, Opg, Rankl e Rank, Trap, Ctsk, Vtn, Itga5 e Itgb5, além de aumento na produção de TNF-α, IL-6, IL-10 e CXCL3 na mandíbula, o que foi reduzido em animais depletados de MC. No fêmur, a DP não levou a alterações da arquitetura óssea, mas foi capaz de aumentar a expressão de Runx2, Opn, Opg, Rankl, Rank, Trap, Mmp2, Mmp9, Vtn, Itga5 e Itgb5, o que também foi significativamente reduzido pela depleção de MC. Conclusões: Nossos dados sugerem um importante papel dos MC nas consequências ósseas locais (mandíbula) da DP, especialmente nos animais SHR, além dos efeitos sistêmicos (fêmur) onde os MC possivelmente têm participação na modulação da expressão de marcadores ósseo, alterados pela DP, o que foi mediado por vias diferentes das observadas na resposta local. / Introduction: Periodontal disease (PD) is an inflammatory disorder of the tissues supporting the teeth, which start from the bacterial biofilm accumulation, and results in local and systemic damage. The coexistence of systemic diseases, such as hypertension, can lead to exacerbated inflammation, increased alveolar bone resorption and increased systemic damage. In addition, resident immune cells have an important role in PD progression, however the mast cells (MC) participation is still not well understood. Aims: To evaluate the role of MC in the local (mandible) and systemic (femur) bone metabolism in a normotensive (Wistar) and hypertensive (SHR) rats with PD. Methods: Males Wistar and SHR rats (10-week old) were used. MC depletion was conducted by compound 48/80 treatment and PD was induced by bilateral ligature placed in the lower first molars, which was maintained for 15 days. The identification of MC in the gingival tissue was done by Toluidine Blue staining, alveolar bone loss and bone architecture parameters of mandible and femurs were evaluated by micro-computed tomography, bone markers gene expression on the mandible and femur were evaluated by real time RT-PCR, and the cytokines production was evaluated by ELISA. Key results: We observed a more significant PD-induced bone loss in SHR, compared to Wistar, and MC depletion was able to prevent this loss. PD increased the expression of Opn, Opg/ Rankl/Rank, Trap, Ctsk, Vtn, Itga5 and Itgb5, as well as increased production of TNF-α, IL-6, IL-10 and CXCL3 in the mandible, what was prevented by MC depleted animals. In the femur, PD did not change bone architecture parameters, but was able to increase expression of Runx2, Opn, Opg/Rankl/Rank, Trap, Mmp2, Mmp9, Vtn, Itga5 and Itgb5, which also was significantly reduced by MC depletion. Conclusions: Our data suggest an important role of MC in the local bone consequences (mandible) of PD, especially in SHR, as well the systemic effects (femur), where MC may have a role in bone dynamics by modulating the expression of bone markers, altered by PD, through different mechanism from those observed in the local response. / 15/03965-2