Made available in DSpace on 2015-04-14T13:29:45Z (GMT). No. of bitstreams: 1 425871.pdf: 1344859 bytes, checksum: dba6de98d2d3eb3cdbd945dc1cdefaf6 (MD5) Previous issue date: 2010-08-10 / Objetivos: Verificar se a Endotelina-1 (ET-1) salivar pode representar um biomarcador eficiente para avalia??o de risco e progn?stico do carcinoma espinocelular bucal. Metodologia: Neste estudo, foi realizada coleta de saliva de 20 pacientes saud?veis, 15 pacientes portadores de leucoplasia oral (diagn?stico histopatol?gico de hiperceratose a displasia severa), 14 pacientes que j? tiveram carcinoma espinocelular bucal (CEB) e estavam em um per?odo p?s-tratamento e livres de doen?a por, no m?nimo cinco anos e, 20 pacientes portadores de CEB. A ET-1 foi quantificada na saliva atrav?s do m?todo ELISA. Resultados: N?o houve diferen?a estatisticamente significativa na express?o de ET-1 entre os grupos estudados, mesmo quando pacientes com idade superior a 65 anos ou hipertensos foram exclu?dos da an?lise. Da mesma forma, quando a amostra foi separada por sexo, tamb?m n?o houve diferen?a significativa. Conclus?es: A ET-1 salivar n?o se mostrou um biomarcador eficiente do carcinoma espinocelular bucal.

Made available in DSpace on 2015-04-14T13:30:20Z (GMT). No. of bitstreams: 1 447196.pdf: 4126470 bytes, checksum: d77c48b36e3a59f55f25d7e5ac89dffd (MD5) Previous issue date: 2013-03-26 / This study aimed at analyzing the activity of the salivary alpha-amylase enzyme (SAA), levels of stress and anxiety of patients with recurrent aphthous stomatitis (RAS), as well as the impact of this disease on the life quality. The sample consisted of 52 adult patients, distributed in RAS group (n=22) and control group (n=30), matched for sex and age. For the investigation of stress symptoms the Lipp s Inventory of Stress Symptoms for Adults and for anxiety, the Beck Anxiety Inventory were used. The World Health Organization Quality of Life-bref (WHOQOL-BREF) and the Oral Health Impact Profile-14 (OHIP-14) tests were used to evaluate the overall life quality and the life quality related to oral health respectively. Saliva samples were collected in the morning and afternoon and the activity of the salivary alpha-amylase enzyme was analyzed by enzymatic kinetic method with the Salivary α-Amylase Assay Kit. No significant difference was observed between groups regarding the SAA activity (P=0.306) in the morning or afternoon samples. Patients in the RAS group had higher scores of anxiety (P=0.016) and, although the prevalence of stress has been higher in this group, there was no significant difference compared to the control group (P=0.498). The scores of physical (P=0.026), psychological (P=0.005), social (P=0.001) and environmental (P=0.040) domains of the WHOQOL-BREF inventory were significantly lower in patients with RAS. The values obtained through OHIP-14 were significantly higher in these patients (P=0.002). We can conclude that RAS negatively affects the life quality of individuals. Patients with the disease have higher levels of anxiety, suggesting its possible association with the etiopathogenesis of RAS. Moreover, despite being a biomarker of stress, the release of SAA oscillates 11 rapidly and may be influenced by several factors, not being efficient for the evaluation of psychological changes in patients with RAU in this study. / Este estudo teve como objetivo analisar a atividade da enzima alfa-amilase salivar (AAS), os n?veis de estresse e de ansiedade de pacientes com ulcera??o aftosa recorrente (UAR), bem como o impacto que esta doen?a exerce na qualidade de vida dos indiv?duos. A amostra foi constitu?da por 52 pacientes adultos, distribu?dos em grupo UAR (n=22) e grupo-controle (n=30), emparelhados por g?nero e idade. Para a investiga??o dos sintomas de estresse foi utilizado o Invent?rio de Sintomas de Stress para Adultos de Lipp e para a ansiedade, o Invent?rio de Ansiedade de Beck. Os question?rios World Health Organization Quality of Life-bref (WHOQOL-abreviado) e Oral Health Impact Profile-14 (OHIP-14) foram utilizados para avalia??o da qualidade de vida geral e relacionada ? sa?de bucal, respectivamente. As amostras de saliva foram coletadas pela manh? e ? tarde, e a atividade da enzima alfa-amilase salivar foi analisada por m?todo cin?tico enzim?tico com o Salivary α-Amylase Assay Kit. N?o foi observada diferen?a significativa entre os grupos quanto ? atividade da AAS (p=0.306) nas amostras da manh? ou da tarde. Os pacientes do grupo UAR apresentaram escores superiores de ansiedade (p=0.016) e, embora a preval?ncia de estresse tenha sido superior neste grupo, n?o houve diferen?a significativa quando comparado ao grupo-controle (p=0.498). Os escores dos dom?nios f?sico (p=0.026), psicol?gico (p=0.005), social (p=0.001) e meio ambiente (p=0.040) do invent?rio WHOQOL-abreviado foram significativamente inferiores nos pacientes com UAR. Os valores obtidos por meio do OHIP-14 foram significativamente superiores nestes pacientes (p=0.002). Com base nos resultados deste estudo, pode-se concluir que a UAR afeta negativamente a qualidade de vida dos indiv?duos. Pacientes com a doen?a apresentam maiores 9 n?veis de ansiedade, evidenciando sua poss?vel associa??o ? etiopatogenia da doen?a. Por outro lado, apesar de a AAS ser um marcador biol?gico de estresse, sua libera??o oscila rapidamente e pode ser influenciada por diversos fatores, n?o tendo sido eficaz para avalia??o de altera??es psicol?gicas em pacientes com UAR neste estudo.

Made available in DSpace on 2015-04-14T13:30:35Z (GMT). No. of bitstreams: 1 459313.pdf: 1355539 bytes, checksum: 3f86f9475d13797bdaa6dc5fdc2f3210 (MD5) Previous issue date: 2014-04-25 / Xerostomia and hyposalivation are important sequelae of head and neck radiotherapy and may have a negative impact on quality of life. The present study aimed to evaluate the effects of low level laser therapy (LLLT) on hyposalivation, xerostomia and quality of life related to oral health (QLROH) in irradiated patients. Were selected 23 patients with a history of head and neck malignancy, treated with fractioned teletherapy, whose therapeutic site had involved at least 50% of the major salivary glands. Patients should have completed radiotherapy for at least six months and present hyposalivation and xerostomia. The sample was randomly distributed in laser group (n=12) and control (n=11). A GaAlAs laser, at 830 nm (infrared) wavelength, 100 mW power, 2 J energy per point was used. Patients underwent twelve sessions of LLLT, applied in parotid, submandibular and sublingual glands. In the control group, the laser tool received a plastic tip that blocked radiation emission. Stimulated and unstimulated salivary flow rate was assessed at baseline, after the 6th and 12th session. Xerostomia was assessed by Visual Analogue Scale (VAS) and QLROH, through the Oral Health Impact Profile (OHIP - 14). The results showed no significant difference between the laser and control groups regarding the salivary flow rate, xerostomia or quality of life. However, at the end of the treatment, the xerostomia and the QLROH showed significant improvement in both groups compared to assessments carried out in baseline. Based on the results, we conclude that, in the parameters used, LLLT was not able to increase salivary flow rate or decrease xerostomia. The results may be associated to the late effects of radiotherapy on glandular structure such as fibrosis and acinar atrophy. The improvement in xerostomia and quality of life highlights the importance of advice given to the irradiated patients and their follow-up. / A xerostomia e a hipossaliva??o s?o importantes sequelas da radioterapia de cabe?a e pesco?o e podem ter impacto negativo na qualidade de vida dos pacientes. O presente estudo teve como objetivo realizar uma revis?o de literatura destas sequelas e avaliar o efeito da terapia laser de baixa pot?ncia (TLBP) na hipossaliva??o, xerostomia e qualidade de vida relacionada ? sa?de bucal de pacientes submetidos ? radioterapia em cabe?a e pesco?o. Foram selecionados 23 pacientes com hist?rico de neoplasia maligna em regi?o de cabe?a e pesco?o, tratados por meio de teleterapia fracionada, cujo portal tenha envolvido ao menos 50% das gl?ndulas salivares maiores. Todos deveriam ter finalizado a radioterapia h? pelo menos seis meses e apresentar hipossaliva??o e xerostomia. A amostra foi aleatoriamente distribu?da em grupos laser (n=12) e controle (n=11). Foi empregado laser de AsGaAl no comprimento de onda de 830 nm (infravermelho), pot?ncia de 100 mW e energia de 2 J por ponto. Os pacientes foram submetidos a doze sess?es de TLBP, aplicada pontualmente em ambas as gl?ndulas par?tidas, submandibulares e sublinguais. No grupo-controle foi adaptado ao aparelho de laser um dispositivo que impedia a emiss?o de radia??o. O fluxo salivar em repouso e sob est?mulo foi avaliado em baseline, ap?s a 6? e a 12? sess?o de TLBP. A xerostomia foi avaliada por meio de Escala Visual Anal?gica (EVA) e a qualidade de vida relacionada ? sa?de bucal, por meio do instrumento Oral Health Impact Profile (OHIP-14). Os resultados demonstraram n?o haver diferen?a significativa entre os grupos laser e controle quanto ? velocidade do fluxo salivar, xerostomia ou qualidade de vida. Por outro lado, em ambos os grupos ao final do tratamento, houve redu??o significativa da xerostomia e melhora da qualidade de vida relacionada ? sa?de oral. Com base nos resultados, pode-se concluir que a TLBP, nos par?metros utilizados, n?o foi capaz de promover eleva??o clinicamente detect?vel do fluxo salivar ou redu??o da xerostomia. Os resultados podem estar associados aos efeitos tardios da radioterapia na estrutura glandular tais como fibrose e atrofia acinar. A melhora dos ?ndices subjetivos xerostomia e qualidade de vida em ambos os grupos ressalta a import?ncia da orienta??o e acompanhamento dos pacientes irradiados.

Objetivo: O objetivo deste ensaio clínico duplo-cego randomizado e cruzado foi avaliar se a presença de álcool nas formulações de clorexidina e de óleos essenciais é capaz de influenciar significativamente a quantidade bacteriana em saliva, assim como verificar o impacto da presença do álcool sobre a percepção gustativa. Materiais e métodos: 20 indivíduos, 17 mulheres e 3 homens, com idades variando entre 18 a 38 anos, em bom estado de saúde, foram randomizados para bochechar de forma cruzada, as seguintes substâncias: gluconato de clorexidina com álcool, gluconato de clorexidina sem álcool, óleos essenciais com álcool e óleos essenciais sem álcool. Amostras de saliva estimulada foram colhidas antes e depois de cada bochecho e preparadas em meio de cultura viável para um amplo espectro de bactérias. Os resultados obtidos foram expressos em percentual de redução de UFC/ml de saliva. Uma escala visual analógica (EVA) foi usada para avaliar a percepção gustativa após cada bochecho Resultados: Não foram observadas diferenças significativas sobre o percentual de redução de bactérias salivares em relação às soluções de clorexidina (p = 0,55), ou de óleos essenciais (p = 0,85). Já a preferência gustativa em relação aos óleos essenciais foi fortemente afetada pela presença de álcool (p= 0,0001), o que não ocorreu na comparação entre as soluções de clorexidina (p=0,052). Conclusão: a presença do álcool não interfere na eficácia antimicrobiana de colutórios a base de clorexidina ou óleos essenciais. A presença de álcool nos óleos essências é avaliada de forma mais negativa em termos de percepção gustativ. / Objective: The objective of this randomized, double-blind crossover clinical trial was to evaluate the presence of alcohol in chlorhexidine and essential oils formulations is able to significantly influence the bacterial quantity in saliva, as well as to check the impact of the presence of alcohol on taste perception. Methods: 20 subjects, 17 women and three men, aged between 18 and 38 years old, in good health, were randomized to rinse crosswise, the following substances: chlorhexidine gluconate with alcohol, chlorhexidine gluconate without alcohol, essential oils with alcohol and essential oils without alcohol. Stimulated saliva samples were collected before and after each rinse and prepared in the midst of viable culture for a broad spectrum of bacteria. The results were expressed as percent reduction of CFU/ml saliva. A visual analogue scale (VAS) was used to evaluate the taste perception after each rinse Results: No statistically significant differences were observed in bacterial reduction between the Chlorhexidine (p = 0.55), as well as for the essential oils (p = 0.85) formulations. However, the taste preference in relation to essential oils was strongly affected by the presence of alcohol (p = 0.0001), which did not occur in the comparison between the chlorhexidine solutions (p = 0.052). Conclusion: The presence of alcohol does not interfere in the antimicrobial efficacy of chlorhexidine or essential oils. The presence of alcohol in the essences oils is evaluated more negatively in terms of taste perception.

La dengue est une maladie virale des régions tropicales et subtropicales, transmise par les moustiques du genre Aedes. Le virus de la dengue (DENV) appartient à la famille des Flaviviridae, genre Flavivirus. Si la plupart des infections sont asymptomatiques ou se traduisent par un syndrome fébrile sans gravité, le virus peut aussi causer une maladie plus sévère caractérisée par une fuite plasmatique, avec ou sans hémorragie. Sans prise en charge adéquate, les formes les plus sévères peuvent évoluer vers un syndrome de choc, potentiellement mortel. Il n’existe pas de traitement spécifique de la dengue mais une réhydratation adaptée et débutée précocement permet de réduire la survenue de formes sévères de la maladie. Malheureusement, les symptômes initiaux de la dengue avant la survenue des éventuelles complications ne sont pas spécifiques et seul un diagnostic biologique basé sur la détection du génome viral, de l’antigène NS1 ou des anticorps anti-DENV dans le sang des patients permet de confirmer la nature exacte de l’infection. La dengue constitue à l’heure actuelle un problème majeur de santé publique du fait de son expansion mondiale et de l’augmentation annuelle du nombre de cas sévères. Pour assurer la surveillance épidémiologique et le contrôle de la maladie, il est indispensable de développer des outils diagnostiques performants et faciles à mettre en œuvre, à la fois utilisables par les médecins de toutes les structures médicales, des simples centres de soins de santé primaire aux centres de référence, et utilisables lors d’enquêtes épidémiologiques pour l’investigation de nouvelles épidémies. Le travail de cette thèse a porté sur plusieurs aspects de cette problématique. Dans une première partie, un test commercial de diagnostic rapide (TDR) permettant la détection simultanée de la NS1 et des IgG et IgM anti-DENV, a été évalué, en laboratoire spécialisé et sur le terrain, afin de comparer, à partir des mêmes échantillons, les performances du test dans deux situations différentes. La sensibilité s’est révélée plus faible lors de l’utilisation sur le terrain que lors de l’utilisation en laboratoire de référence. La majorité des discordances a été observées pour la détection des IgG et des IgM. L’impact de la mise à disposition du test sur la prise en charge des patients a également été évalué et il s’est avéré qu’au cours de cette étude les pédiatres cambodgiens ont ignorés les résultats du test rapide et ont préféré suivre leur instinct clinique.Un second volet a porté sur la faisabilité d’utiliser les urines et la salive en remplacement du sang veineux pour les tests employés en routine pour le diagnostic de la dengue. Les urines et la salive sont des fluides biologiques plus faciles à prélever que le sang veineux ce qui présente un avantage majeur pour les enquêtes épidémiologiques mais peut également secourir les médecins lorsqu’un prélèvement de sang veineux est difficile à obtenir, par exemple chez les enfants. Bien que les performances des différentes méthodes de diagnostic ne soient pas aussi bonnes avec de l’urine et la salive qu’avec du plasma, les résultats obtenus par PCR en temps réel et avec les ELISAs de détection des anticorps anti-DENV démontrent l’intérêt potentiel de ces deux fluides biologiques pour détecter les infections par le DENV lorsqu’il est difficile d’obtenir du sang veineux. Plusieurs TDR commerciaux développés pour permettre la détection de la NS1 et des anticorps anti-DENV (IgM, IgG et IgA) dans les urines et la salive ont été évalués mais les performances obtenues se sont révélées peu satisfaisantes.Une dernière partie du travail a été consacrée à l’étude de la protéinurie comme marqueur pronostic potentiel de sévérité de la dengue. Ce marqueur biologique ne s’est pas révélé être utile pour diagnostiquer précocement les formes sévères de la maladie. / Dengue is a viral disease transmitted by Aedes species mosquitoes, in tropical and subtropical regions. Dengue virus (DENV) belongs to the family Flaviviridae, genus Flavivirus. Although most DENV infections are asymptomatic or result in a self-limited febrile illness, severe diseases characterized by plasma leakage, with or without hemorrhage, can also occur. Patients with a severe dengue can rapidly progress into a life-threatening shock syndrome if no efficient clinical management is provided. There is no specific treatment available for dengue but an accurate and early fluid therapy substantially reduces the occurrence of severe forms of the disease. Dengue symptoms are typically non-specific until or unless complications develop. Only a biologic diagnosis based on DENV genome, NS1 antigen or anti-DENV antibodies detection enables to confirm dengue cases. Dengue is now a major public health problem due to both its geographical spread and the increase in the number of severe cases. New diagnostic tools are necessary to ensure epidemiological surveillance and control of the disease. These tools need to be effective and easy to use in every medical settings, from the smallest primary health centers to the biggest reference centers, and also usable for epidemiologic studies, e.g. for epidemic investigations. The work presented in this thesis was dedicated to this problematic.In a first part of the work, a rapid diagnostic test (RDT), designed to detect NS1 antigen, anti-DENV IgG and IgM, was evaluated, both in a specialized laboratory and in the field, in order to compare the test performances in two different settings, with the same samples. Interestingly, sensitivity was lower when the test was used in the field compared to the sensitivity of the test when performed in the specialized laboratory. Discordances were mainly observed for IgM and IgG detection. Impact of the use of the RDT on clinical management was also assessed during the field study and it revealed that Cambodian pediatricians ignored the results of the RDT and followed their clinical instinct.A second part of the work was dedicated to the assessment of the usefulness of urine and saliva for dengue diagnostic. Dengue diagnostic normally requires a venous blood sample that can be difficult to obtain in certain conditions such as in children or during epidemiological studies. Urine and saliva are easier to collect as the procedure is non-invasive. We showed that, although the performances of the different diagnostic methods were not as good in saliva and urine as in plasma specimens, the results obtained by qRT-PCR and by anti-DENV antibody ELISA could well justify the use of these two body fluids to detect dengue infection in situations when the collection of blood samples is difficult. Performances of commercial RDTs developed for NS1 and anti-DENV antibodies (IgM, IgG and IgA) detection in urine and saliva specimens were not satisfactory.In the last part of the thesis, the potential use of proteinuria as a prognostic marker of severity was assessed but it didn’t prove to be a useful marker for risk prediction.

Submitted by Márcio Ropke (ropke13marcio@gmail.com) on 2017-06-12T14:24:50Z No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Potencial cariogênico do biofilme originado de inóculos de origem salivar e da.pdf: 1557184 bytes, checksum: 05a976493bb42a87794051f4a3bd098e (MD5) / Made available in DSpace on 2017-06-12T14:24:50Z (GMT). No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Potencial cariogênico do biofilme originado de inóculos de origem salivar e da.pdf: 1557184 bytes, checksum: 05a976493bb42a87794051f4a3bd098e (MD5) Previous issue date: 2015-02-19 / Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPq / Modelos de biofilmes de microcosmos in vitro originados de inóculos salivares ou da placa dental demonstraram que o tipo de inóculo leva a diferentes microcosmos, o que poderia influenciar o potencial cariogênico dos biofilmes in vitro. Dessa forma, o presente estudo investigou o potencial cariogênico de biofilmes originados de diferentes tipos de inóculo (saliva e placa dental), de indivíduos cárie-ativos e livres de cárie, em um modelo de biofilme de microcosmos. Dez voluntários foram selecionados de cada condição de cárie (livres de cárie e cárie-ativos) para coleta pareada de placa dental e saliva. Biofilmes de microcosmos foram iniciados, a partir do inóculo, sobre espécimes de esmalte individualmente dispostos em placas de 24 poços. Os biofilmes cresceram em meio definido enriquecido com mucina (DMM), e foram submetidos a desafio cariogênico (DMM suplementado com sacarose à 1%) por 6h/dia. Após 10 dias, os biofilmes foram coletados para análise das variáveis de desfecho: perda mineral (porcentagem de mudança de dureza de superfície) e composição microbiológica dos biofilmes (contagem das UFCs – Unidades Formadoras de Colônias). Análise estatística foi realizada com testes T, Modelo de Análise Multivariada Linear e coeficiente de correlação de Pearson. A análise comparativa entre os dados microbiológicos de baseline para os tipos de inóculos (saliva e placa dental) não mostrou diferença estatística para os indivíduos livres de cárie, já para cárie-ativos foi estatisticamente significante somente para estreptococos mutans. Quanto à comparação entre indivíduos com diferentes condições de cárie, houve diferença estatisticamente significante para estreptococos mutans e microrganismos ácido-tolerantes nas amostras de placa dental, e para ácido-tolerantes na saliva. Após 10 dias de crescimento dos biofilmes, sob desafio cariogênico, os valores para microrganismos totais, lactobacilos, estreptococos mutans, ácido-tolerantes; e ainda, para a perda de dureza de superfície (%PDS), não foram estatisticamente significantes, considerando o tipo de inóculo e a condição de cárie. Correlação positiva foi encontrada para %PDS e contagem de UFCs das bactérias ácido-tolerantes (r=0.406) e lactobacilos (r=0.379). Dentro das limitações do presente estudo pode-se concluir que, independente de diferenças iniciais entre a origem e o tipo de inóculo, o potencial cariogênico de biofilmes formados sob condições idênticas neste modelo de biofilme de microcosmos é similar. / In vitro microcosm’s biofilm models originated from salivary or plaque inoculum demonstrated that the type of inoculum leads to different microcosms, which could influence the cariogenic potential of in vitro biofilms. Thus, the aim of this study was to investigated the cariogenic potential of biofilms originating from different types of inoculum (saliva and dental plaque) from individuals with active caries and caries-free, in a microcosm biofilm model. Ten volunteers were selected from each caries condition (caries-free and caries-active) for paired collecting of saliva and dental plaque. Biofilm microcosms were originated from the inoculum on enamel specimens arranged individually in 24-well plates. Biofilms grown in defined medium enriched with mucin (DMM), and were subjected to cariogenic challenge (DMM supplemented with sucrose at 1%) for 6h/day. After 10 days, the biofilms were collected for analysis of outcome variables: mineral loss (percentage of surface hardness change) and microbiological composition of biofilms (count of CFUs - Colony Forming Units). Statistical analysis was performed using t-test, Linear Multivariate Analysis Model and Pearson's correlation coefficient. The comparative analysis between microbiological baseline data for types of inoculum (saliva and dental plaque) was not significantly different for individuals free of caries, and for caries-active was statistically significant only for mutans streptococci. Comparison between individuals with different caries conditions, was statistically significant for mutans streptococci and acid-tolerant microorganisms in dental plaque samples, and acid-tolerant in saliva. After 10 days of growth of biofilms under cariogenic challenge, the values for total microorganisms, lactobacilli, streptococci mutans, acid-tolerant; and also to the surface hardness change (% SHC), were not statistically significant, considering the type of inoculum and the caries condition. Positive correlation was found for % SHC and CFUs counts of acid-tolerant bacteria (r=0.406) and lactobacilli (r=0.379). Under the limits of this study, the cariogenic potential of biofilms, formed under identical conditions in vitro on this microcosm biofilm model is similar, regardless of initial differences found between the source and type of inoculum.

Resumo: O objetivo do presente estudo foi avaliar a microbiota bucal de mães, e pares de crianças, atendidas no programa educativo-preventivo da Bebê Clínica da Faculdade de Odontologia de Araçatuba-UNESP, nas faixas etárias de 6, 12, 18 e 24 meses, relacionando-a com a dieta, higiene bucal, presença ou não de dentes, prevalência de cárie e condição gengival. Após exame clínico e levantamento da dieta alimentar das crianças, foi realizada coleta dos espécimes de saliva, biofilme nas faixas etárias determinadas, que foram transferidos para frascos contendo meio de transporte VMGA III, submetidos a diluições seriadas em VMGA I, seguido de inoculação em meios de cultura adequados e incubação em diferentes condições redox e períodos de tempo. Além disso, a identificação dos isolados foi também realizada através de amplificação do DNA por PCR, após armazenamento dos espécimes em água ultra pura, e os níveis salivares de estreptococos do grupo mutans foram avaliados por real-time PCR. Nas faixas etárias avaliadas, não se observou correlação entre prevalência de patógenos orais e tipo de hábitos de dieta e higiene oral, sendo esta relacionada ao número de dentes irrompidos, principalmente com relação à prevalência de cocos cariogênicos e suas populações. Os microrganismos mais freqüentemente detectados aos 6 meses, pertenciam ao gênero Actinomyces, Campylobacter rectus, e à espécie Fusobacterium nucleatum. De maneira geral, aos 6 meses, a colonização da cavidade bucal dos bebês, por esses microrganismos, era transitória, por vezes não sendo observados em coletas subseqüentes. Aos 12 meses, observou-se uma elevação na prevalência de Actinomyces sp., Fusobacterium nucleatum e Streptococcus sobrinus. Nesta faixa etária, a presença de Eikenella corrodens foi... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: The purpose of this study was to evaluate oral microorganisms of 50 infants and their mothers, in the ages of 6, 12, 18 and 24 months, integrants of Baby-Clinic's preventive program (Dental School of Aracatuba- UNESP). This factor was related to diet, oral hygiene habits, presence of teeth, prevalence of caries and periodontal conditions. After clinical exam, saliva and oral biofilm were collected and stored for culture and PCR process. Salivary levels of Streptococcus mutans were measured by Real time PCR. In the ages of the infants examined, after statistical analysis, it could be observed that no correlation was found between presence of oral pathogens and diet and hygiene habits, otherwise, this correlation could be seen with increase of erupted teeth. Most frequent microorganisms found in oral flora of infants at six months were Actinomyces, Campylobacter rectus and Fusobacterium nucleatum. Microorganisms observed at one period, could not be found in the other, suggesting that it was not a resident flora. At 12 months, data revealed increase in prevalence of Actinomyces sp., Fusobacterium nucleatum e S. sobrinus. In this age, the presence of Eikenella corrodens was significant. At 18 months, significant increase in the population of Actinomyces sp., Eikenella corrodens, Fusobacterium nucleatum, Streptococcus mutans e S. sobrinus was found. At 24 months, oral microflora was similar to the anterior but Streptococcus mutans and S. sobrinus, had an increase of population. Positive correlation between microorganisms found in mouth of mother and children in all periods was observed. For this reason, educative and preventive measures, which aim control of oral biofilm, must be priority, and made associated with attendance of the infants, as mothers are main transmissive ways to their children. Besides, the control of oral biofilm, as eruption... (Complete abstract click electronic access below) / Orientador: Robson Frederico Cunha / Coorientador: Elerson Gaetti Jardim Júnior / Banca: Sandra Maria Herondina Coelho Ávila de Aguiar / Banca: Renato Moreira Arcieri / Banca: Leila Maria Cesário Pereira Pinto / Banca: Edo Hirata / Doutor

This work investigated the design parameters necessary for the build and use of an in vitro artificial mouth model built for dental erosion research. It also ascertained the working knowledge of dentists concerning the Human Tissue Act (HTA) and explored an alternative tissue for erosion-testing to human enamel. The design inputs for the artificial mouth were acquired by an innovative observational study conducted upon human volunteers and used in the decisions made in the setting of the fluids’ kinematic behaviour and how the associated devices were to function. This novel system was sought to mimic the interaction of saliva and the dental substrate during the process of consuming an erosive beverage. The model allows researchers to gather data using customizable experimental diets without the technical burden of dealing with a non-realistic regime. The design and build of the artificial mouth model along with its associated equipment and parameters are described and a manual for operation of the model is appended. The device is designed on a fully adjustable multitask basis in which the operator can set several variables such as the desirable salivary kinematic behaviour, offensive beverage flow rate, and volume of consumption. This, subsequently, allows the samples preloaded on the system to be tested for surface characteristics (i.e. surface hardness and surface profilometry) to determine the extent of erosion if any. The model also allows the resultant solution to be analysed for traces of calcium and phosphate ions. To validate the capabilities of the artificial mouth system a set of diets was performed repeatedly. The high degree of agreement and the consistency of results showed that the model is able to mimic realistic scenarios and is capable of producing reliable, reproducible and accurate outcomes. Ostrich eggshell proved to be a potential alternative erosion substrate which is fortuitous as the lack of knowledge on the HTA had meant human enamel was less readily available.

El presente estudio se realizó con el propósito de determinar la prevalencia de caries dental, volumen de flujo salival, grado de pH y la capacidad amortiguadora de la saliva en los adolescentes con Síndrome de Down comparándolos con adolescentes sin Síndrome de Down. Para ello, se evaluaron muestras de saliva no estimulada a 25 adolescentes con Síndrome de Down y 25 adolescentes sin Síndrome de Down con edades comprendidas entre 12 y 15 años de edad. Se determinó la prevalencia de caries dental, el volumen del flujo salival, el grado de pH salival y la capacidad amortiguadora de la saliva. El índice de CPO-D de los adolescentes con Síndrome de Down fue de 3.32 + 0.802 y el de los adolescentes sin Síndrome de Down fue de 4.52 + 1.503, El valor promedio de flujo salival del de los adolescentes con Síndrome de Down fue de 0.556 + 0.961 y de los adolescentes sin Síndrome de Down fue de 0.48 + 0.139. Se encontró que existe diferencia estadísticamente significativa en ambas variables. En los adolecentes con Síndrome de Down el pH salival promedio fue de 7.16 + 0.473 y del grupo de los adolescentes sin Síndrome de Down el pH salival promedio fue de 7.08 + 0.640. En cuanto a los niveles de la capacidad amortiguadora, se observó que el mayor porcentaje (68%) de adolescentes con Síndrome de Down tuvieron una capacidad amortiguadora alta. En cambio, el mayor porcentaje de adolescentes sin Síndrome de Down 84% tuvieron una capacidad amortiguadora media. Se concluye que la prevalencia de caries dental en adolescentes con Síndrome de Down fue menor que la de los adolescentes sin Síndrome de Down. Además, que el volumen del flujo salival es mayor en los adolescentes con síndrome de Down y que la capacidad amortiguadora es alta en estos tipos de pacientes. PALABRAS CLAVES: Adolescentes con Síndrome de Down - Adolescentes sin Síndrome de Down-Prevalencia de caries dental - Volumen de flujo salival - Grado de pH salival- Capacidad amortiguadora. / Tesis

Los cambios en el embarazo pueden predisponer al desarrollo de caries al aumentar los recuentos de bacterias cariogénicas y aumentar el riesgo de infección de sus hijos, con el consecuente riesgo de desarrollar caries. El odontólogo debe tener en cuenta que durante el embarazo se observa una mayor apetencia por los alimentos dulces, en este periodo, junto con la alteración de los hábitos de higiene oral, que da lugar a un aumento de la incidencia de caries, debido a los deseos de comer entre comidas y generalmente dulces ricos en azúcares. Cada vez que se ingiere dulces, los ácidos que se generan por la ingestión de los mismos, varían el pH y flujo salival, atacando durante aproximadamente 30 minutos la superficie dental. Durante el periodo gestacional, la composición salival se ve alterada, existe una variación del pH salival y la capacidad buffer, en consecuencia, la función para regular los ácidos producidos por las bacterias se ve afectada, ocasionando en gran medida, un medio bucal favorable para el crecimiento y cambios en las poblaciones bacterianas. Es importante el control odontológico durante el periodo gestacional, tanto desde el punto de vista de la prevención como del tratamiento, ya que está comprobado que estas actividades en la mujer embarazada tienen efectos positivos en ella como en su descendencia. El contagio de bacterias cariogénicas en la boca del niño, proviene especialmente de la saliva de la madre, durante la erupción de las piezas dentarias. Se ha demostrado que mientras más precoz es la colonización de la boca por las bacterias cariogénicas, mayor es el riesgo de tener caries a corto plazo. El propósito del estudio fue analizar los cambios salivales (pH y flujo salival) que ocurren en cada trimestre del periodo gestacional y conocer la importancia de las medidas preventivas para ser aplicadas en cada trimestre del periodo gestacional. / Tesis