Made available in DSpace on 2014-12-17T15:32:30Z (GMT). No. of bitstreams: 1 BrunaAA_TESE.pdf: 3866204 bytes, checksum: 7934d035171f609056bc3ea2c84219b1 (MD5) Previous issue date: 2011-02-16 / Periodontal disease is an infection initiated by oral periodontal pathogens that trigger an immune response culminating in tissue destruction. This destruction is mediated by the host by inducing the production and activation of lytic enzymes, cytokines and the stimulation of osteoclastogenesis. The aim of this study was to compare the immunohistochemical expression of factors involved in bone resorption, RANKL (Ligand Receptor Activator of Nuclear Factor kappa B), OPG (Osteoprotegerin) and TNF-&#945; (tumor necrosis factor alpha) between the gingival healthy, gingivitis and chronic periodontitis and correlate them with clinical parameters. The sample consisted of 83 cases and 12 clinically healthy gums, 42 gingivitis and 29 periodontitis, from 74 adolescent and adult patients with a mean age of 35 years, without systemic changes and non-smokers, predominantly female and race brown. There was no statistically significant difference for the expression of anti-RANKL (p = 0.581) and RANKL / OPG ratio (p = 0.334) when comparing the three conditions, but the anti-OPG and anti-TNF-&#945; showed statistically significant between the types of injury (p = 0.001 and p <0.001, respectively), showing greatest expression in periodontitis. In cases of periodontitis, the variable clinical attachment loss (PIC) was statistically significant and positive correlation, respectively, with immunostaining of anti-RANKL (p = 0.002, p = 0.001 and r = 0.642), anti-OPG (p = 0.018, p = 0.014 and r = 0.451), anti-TNF-&#945; (p = 0.032, p = 0.014 and r = 0.453) and the percentage ratio of RANKL / OPG (p = 0.018, p = 0.002 and r = 0.544). The tooth mobility (MB) showed a statistically significant difference only with immunohistochemical anti-RANKL (p = 0.026), and probing depth (PD) was positively correlated with anti-RANKL (p = 0.028 and r = 0.409), both in cases of periodontitis. Only in cases of gingivitis TNF-&#945; was positively correlated with RANKL (p = 0.012 and r = 0.384) and the RANKL / OPG ratio (p = 0.027 and r = 0.341). Given these results, we conclude that the greatest expression of TNF-&#945; in periodontitis demonstrates a relationship with the progression and severity of periodontal disease and the correlation between all antibodies and clinical attachment loss demonstrates their involvement in periodontal bone resorption / A doen?a periodontal ? uma infec??o oral iniciada por periodontopat?genos que desencadeiam a resposta imune culminando com a destrui??o tecidual. Essa destrui??o ? mediada pelo hospedeiro atrav?s da indu??o da produ??o e ativa??o de enzimas l?ticas, citocinas e da estimula??o da osteoclastog?nese. O objetivo deste estudo foi comparar a express?o imuno-histoqu?mica dos fatores envolvidos na reabsor??o ?ssea, RANKL (Ligante do Receptor Ativador do Fator Nuclear kappa B), OPG (Osteoprotegerina) e TNF-&#945; (Fator de Necrose Tumoral Alfa) entre a gengiva clinicamente saud?vel, a gengivite e a periodontite cr?nica, correlacionando-os com os par?metros cl?nicos periodontais. A amostra consistiu de 83 casos, sendo 12 de gengivas clinicamente saud?veis, 42 de gengivite e 29 de periodontite, oriundos de 74 pacientes adolescentes e adultos com idade m?dia de 35 anos, sem altera??es sist?micas e n?o fumantes, predominantemente do sexo feminino e da ra?a parda. N?o houve diferen?a estatisticamente significativa para express?o do anticorpo anti-RANKL (p=0,581) e da raz?o RANKL/OPG (p=0,334) quando se comparou as tr?s condi??es cl?nicas, mas o anti- OPG e anti-TNF-&#945; mostraram diferen?as estatisticamente significativas entre os tipos de les?o (p=0,001 e p<0,001, respectivamente), revelando maior imunoexpress?o na periodontite. Nos casos de periodontite, a vari?vel perda de inser??o cl?nica (PIC) mostrou diferen?a estatisticamente significativa e correla??o positiva, respectivamente, com a imunomarca??o dos anticorpos anti-RANKL (p=0,002; p=0,001 e r=0,642), anti-OPG (p=0,018; p=0,014 e r=0,451), anti-TNF-&#945; (p=0,032; p=0,014 e r=0,453) e com a raz?o percentual de RANKL/OPG (p=0,018; p=0,002 e r=0,544). A mobilidade dent?ria (MB) apresentou diferen?a estatisticamente significativa somente com a imunoexpress?o do anti-RANKL (p=0,026), e a profundidade de sondagem (PS) apresentou correla??o positiva com o anti- RANKL (p=0,028 e r=0,409), ambos nos casos de periodontite. Somente nos casos de gengivite o TNF-&#945; apresentou correla??o positiva com o RANKL (p=0,012 e r=0,384) e com a raz?o RANKL/OPG (p=0,027 e r=0,341). Diante desses resultados, conclui-se que a maior imunoexpress?o do TNF-&#945; na periodontite demonstra uma rela??o com a progress?o e severidade da doen?a periodontal e a correla??o entre todos os anticorpos e a perda de inser??o cl?nica demonstra o envolvimento destes na reabsor??o ?ssea periodontal

Made available in DSpace on 2014-12-17T15:30:52Z (GMT). No. of bitstreams: 1 LuanaMMA.pdf: 2018250 bytes, checksum: 40d3a2d59df5edbadcdae3ffaf599eb2 (MD5) Previous issue date: 2009-02-03 / The non-adaptation of the removable partial prosthesis (RPP) base to fibromucosal tissue is caused by resorption of residual ridges (RRR). The onset of bone resorption, which occurs after tooth extraction and continues throughout life, is accelerated by local or systemic factors. Aim: Assess the degree of non-adaptation of removable partial prosthesis saddles and the factors that influence it. Methodology: A sectional study was conducted with 81 patients using RPP who had their prostheses installed between 2003 and 2007 (1 to 5 years of use) at the Faculty of Dentistry of the Universidade Federal do Rio Grande do Norte (UFRN). After anamnese and clinical examination, a cast was made with polyether-based material, using the base of the prosthesis to make the impression. The base of the saddle was loaded with the casting material and positioned in the mouth, applying pressure on the supports. After polymerization, the material was removed from the saddle and measurements were taken at 3 different points using a pachymeter. Results: The non-adaptation of the saddle increased significantly with years of use (p = 0.005). The tooth-tissue supported prostheses obtained higher mean non-adaptation values than those of tooth supported prostheses (p < 0.001). Flaccid mucosa showed the worst non-adaptation results, which were statistically different from resilient mucosa (p < 0.001). The greater the extension of the saddle, the greater the non-adaptation (p < 0.001). The natural tooth antagonistic arch yielded better results than did RPP and total prosthesis (p < 0.001). Saddle non-adaptation at the free end was less near the pillar tooth and greater in the more posterior region (p < 0.001). When adaptation of the supports to the niches was poor, greater saddle non-adaptation occurred than when it was good or fair (p < 0.001). Saddles located in the posterior region of the arch had greater non-adaptation than those in the anterior region (p = 0.023). Conclusion: The mean non-adaptation of the saddle to the residual ridges was 0.27 mm. It can be concluded that, even with the use of RPP, bone height reduction was slight within the 1-5-year period of use. The following are factors that influence adaptation of the RPP saddle base: years of use, age, force transmission path to the alveolar bone, location of the toothless area, antagonistic arch, type of mucosa, adaptation of supports to the niche and extension of the saddle / A desadapta??o da base das pr?teses parciais remov?veis (PPR) com o tecido fibromucoso ? causada pela reabsor??o dos rebordos residuais (RRR). A reabsor??o ?ssea inicia logo ap?s a exodontia de um elemento dent?rio e continua por toda a vida, sendo acelerada por fatores locais ou sist?micos. Objetivo: Avaliar o grau de desadapta??o das selas de pr?teses parciais remov?veis e os fatores que a influenciam. Metodologia: Foi realizado um estudo seccional com 81 pacientes usu?rios de PPR que instalaram suas pr?teses no per?odo de 2003 a 2007 (1 a 5 anos de uso) no Departamento de Odontologia da UFRN. Ap?s a anamnese e do exame f?sico, foi realizada uma moldagem com material a base de poli?ter, utilizando a base da pr?tese como moldeira, para copiar o espa?o existente entre a base da sela e o rebordo residual. A base da sela foi carregada com o material de moldagem e levada em posi??o na boca, fazendo-se press?o sobre os apoios. Ap?s a polimeriza??o, removeu-se o material de moldagem da sela e realizou-se a medi??o da espessura do molde com o aux?lio de um paqu?metro manual. Resultados: A desadapta??o da sela aumentou significativamente a medida que aumentavam os anos de uso (p=0,005). Indiv?duos com 50 anos ou mais, apresentaram maior desadapta??o do que indiv?duos mais jovens (p<0,001). As pr?teses dentomucossuportadas obtiveram maiores m?dias de desadapta??o do que as dentossuportadas (p<0,001). O tipo de mucosa fl?cida apresentou piores resultados de adapta??o sendo estatisticamente diferente da mucosa resiliente (p<0,001). Quanto maior a extens?o da sela, maior a desadapta??o (p<0,001). O arco antagonista dente natural apresentou melhores resultados em rela??o a PPR e pr?tese total (p<0,001). A desadapta??o da sela em extremidade livre foi menor pr?ximo ao dente pilar e maior na regi?o mais posterior da sela (p<0,001). A adapta??o dos apoios aos nichos quando se encontrava ruim obteve maior desadapta??o da sela comparadas as adapta??es do tipo boa e regular (p<0,001). Selas localizadas em regi?o posterior do arco obtiveram maiores desadapta??o que as selas em regi?o anterior (p=0,023). Conclus?o: A m?dia de desadapta??o da sela sobre os rebordos residuais foi de 0,27mm, podendo-se concluir que, mesmo com o uso da PPR, a redu??o da altura ?ssea foi pequena dentro do per?odo de 1 a 5 anos de uso. S?o fatores que influenciam na adapta??o da base da sela de PPR: tempo de uso da pr?tese, idade, via de transmiss?o de for?a para o osso alveolar, local da ?rea desdentada, arco antagonista, tipo de mucosa, adapta??o dos apoios nos nichos e extens?o da sela

Made available in DSpace on 2014-12-17T15:32:29Z (GMT). No. of bitstreams: 1 KaruzaMAP_Tese.pdf: 829792 bytes, checksum: 60cd145c0f060b54f7dfbb5463648200 (MD5) Previous issue date: 2010-02-25 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / The Giant Cell Lesions, both the Central Giant Cells Lesions (CGCL) as the Peripheral Giant Cells Lesions (PGCL), correspond to a group of oral lesions that are histologically similar entities; however they show a variable clinical behaviour. The purpose of this study was to compare the immunohistochemical expression of bone resorption factors RANK (Receptor Activator of Nuclear Factor kappa B), RANKL (Receptor Activator of Nuclear Factor kappa B Ligand) and OPG (Osteoprotegerin) between CGCL and PGCL. Additionally, these bone resorption factors were examined in terms of aggressiveness of these lesions. The sample consisted of 61 cases, 30 cases of PGCL and 31 CGCL (16 non-aggressive and 15 aggressive). The analysis was performed by quantification of mononuclear cells (MO) and giant multinucleated cells (CG) immunopositive to anti-RANK, anti-RANKL and anti-OPG antibodies in 10 fields. Moreover, according to the proportion between the amount of cells positive for RANKL and OPG, the cases were categorized into: RANKL>OPG, OPG>RANKL e RANKL=OPG. CGCL showed a higher amount of MO (p=0.002) and total cells (p=0.003) both positives to RANKL compared with the PGCL. Additionally, the CGCL revealed a significant association with the ratio of RANKL>OPG (p=0.001). Analysis of the bone resorption factors revealed no significant differences between aggressive and non-aggressive CGCL (p>0.05). It was observed a positive correlation between the markers themselves, and a negative correlation between lesion size and quantity of OPG positive MO cells (p=0,004) and total cells (p=0,009). Through these results, we suggest that the greatest CGCL resorptive potential compared to the PGCL, may have occurred to the high expression of RANKL. Furthermore differences in the biological behavior of aggressive and non-aggressive CGCL appear to be related to the expression of these bone resorption factors / As Les?es de C?lulas Gigantes, tanto as Les?es Centrais (LCCG) quanto as Perif?ricas (LPCG), correspondem a um grupo de les?es orais que apresentam-se histologicamente semelhantes, por?m demonstram um comportamento cl?nico vari?vel. O prop?sito deste estudo foi comparar a express?o imuno-histoqu?mica dos fatores de reabsor??o ?ssea RANK (Receptor Ativador do Fator Nuclear kappa B), RANKL (Ligante do Receptor Ativador do Fator Nuclear kappa B) e OPG (Osteoprotegerina) entre LCCG e LPCG. Adicionalmente, esses fatores foram analisados nas LCCG quanto ? agressividade destas. A amostra consistiu de 61 casos, sendo 30 casos de LPCG e 31 de LCCG (16 n?o-agressivos e 15 agressivos). A an?lise foi realizada por meio da quantifica??o das c?lulas mononucleadas (MO) e c?lulas gigantes multinucleadas (CG) imunopositivas aos anticorpos anti-RANK, anti-RANKL e anti-OPG, em 10 campos. Al?m disso, de acordo com a propor??o entre quantidade total de c?lulas positivas para RANKL e para OPG, os casos foram categorizados em: RANKL>OPG, OPG>RANKL e RANKL=OPG. As LCCG apresentaram maior quantidade de MO (p=0,002) e c?lulas totais (p=0,003) positivas para RANKL, em compara??o com as LPCG. As LCCG ainda revelaram uma associa??o significativa com a propor??o de RANKL>OPG (p=0,001). A an?lise dos fatores de reabsor??o ?ssea n?o revelou diferen?as significativas entre LCCG agressivas e n?o-agressivas (p>0,05). Foi constatada correla??o positiva dos marcadores entre si, bem como uma correla??o negativa entre o tamanho das les?es e a quantidade de MO (p=0,004) e c?lulas totais (p=0,009) positivas para OPG. Diante desses resultados, concluise que o maior potencial reabsortivo das LCCG frente ?s LPCG pode ser decorrente da elevada express?o de RANKL. Al?m disso, as diferen?as nos comportamentos biol?gicos de LCCG agressivas e n?o-agressivas parecem n?o estar relacionadas com a express?o desses fatores de reabsor??o ?ssea.