OBJECTIVES: The association between bicuspid aortic valves and aortic aneurysms has been well documented. In order to better understand this association, this study sought to accomplish two goals. The first was to determine if there was any correlation between specific bicuspid aortic valve phenotypes and aortic aneurysms. The second goal was to determine if the association between bicuspid aortic valve disease and aortic aneurysms has a genetic or hemodynamic cause. METHODS: For the non-genetic portion of the study, we used echocardiogram and surgical records to classify the phenotypes of the aortic valve and the aorta of 434 patients. We then evaluated the correlation between valve morphotype and aortic aneurysm phenotype. For the genetic portion, we used a genome wide association study on 452 patients to find genes that could potentially be responsible for aortic aneurysms. These were then compared with genes suspected of causing bicuspid aortic valve to determine if there is a common genetic link between the two disorders. RESULTS: We observed a significant association between bicuspid aortic valve and aortic aneurysms; however we did not find any significant association between the different bicuspid aortic valve phenotypes and aortic aneurysm phenotypes. For the genome wide association study, we identified genes that could potentially be responsible for causing aortic aneurysms; however, none of the suspected markers were considered statistically significant. Also none of the identified genes matched to the genes suspected of causing bicuspid aortic valve. CONCLUSION: While the results were not as expected, the study provided us with information to better understand the relationship between bicuspid aortic valves and aortic aneurysms. According to the results of the current study, patients with bicuspid aortic valve are more likely to develop an aortic aneurysm but specific phenotype has no effect on where the aneurysm occurs in the aorta. The increased frequency of aortic aneurysms in bicuspid valve patients is most probably due to a combination of altered hemodynamics and genetic effects. In order for this information to be useful in the clinical setting, the methods of this study should be repeated in a larger cohort to make sure the results are accurate.

This thesis introduces a framework aimed at developing an aid for physicians to diagnose and manage failing aortic valves using finite element (FE) simulations. The bicuspid aortic valve (BAV) is the most commonly observed valvular defect (Sievers et al. 2007) and therefore used to investigate the clinical utility of FE-based mechanical simulations. For the analysis, patient data was collected using real-time 3D echocardiography (rt3DE) of five normal valves and three pathological. The valve geometries were reconstructed into 3D models including the sinus and leaflet structures. An FE analysis was completed on the models, and the results were critically analyzed and validated with experimental data. Results indicate that human patient aortic valves can be successfully reconstructed and when simulated, realistic deformation is observed. This thesis focused on severity assessment of BAV morphologies through comparison to that of normal aortic valves.

Thesis (M.S.)--University of Michigan, 1972.

Thesis (M.S.)--University of Michigan, 1972.

Orientador: Frab Norberto Bóscolo / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-22T01:44:48Z (GMT). No. of bitstreams: 1 Torres_GinaDeliaRoque_M.pdf: 6495208 bytes, checksum: 797b881a2825dc0c4b6da71903f696a5 (MD5) Previous issue date: 2013 / Resumo: O objetivo neste estudo foi pesquisar qual é a imagem que oferece melhor informação qualitativa e quantitativa, comparando a radiografia panorâmica com a tomografia computadorizada de feixe cônico, na avaliação da relação entre o seio maxilar e os ápices dentais. Para tanto, foi utilizada uma amostra de conveniência de 109 imagens de radiografia panorâmica e de TCFC, dos mesmos pacientes. Três observadores calibrados avaliaram um total de 1.875 ápices, que foram classificados de acordo com sua relação topográfica e mensurados quando o ápice se encontrava aquém ou além do assoalho do seio maxilar, em ambas as modalidades de imagens. Concordância entre as duas técnicas de imagens foram examinadas estatisticamente. Após um intervalo de 30 dias, a avaliação foi repetida em 25% da amostra para avaliar estatisticamente a concordância intraobservador; os valores encontrados para o Kappa ponderado na avaliação qualitativa e o coeficiente de correlação intraclasse para a avaliação quantitativa representaram correlação entre considerável-quase perfeito e excelente, respectivamente. Para observar a concordância entre as duas imagens, o Kappa ponderado na avaliação qualitativa mostrou uma leve concordância para as raízes palatinas dos primeiros molares do lado direito e dos segundo molares. Quando comparados os valores da avaliação quantitativa pelo coeficiente de correlação intraclasse, houve pobre concordância para as raízes palatinas do primeiro molar esquerdo e dos segundos molares, como também para as raízes mesiovestibulares dos segundos molares direitos e disto-vestibulares dos segundos molares esquerdos. Concluiu-se que há uma baixa concordância entre as duas modalidades de imagens quando as raízes se encontram em contato com o assoalho do seio maxilar ou quando foi observada uma projeção das raízes além do assoalho do mesmo na radiografia panorâmica; e uma alta concordância da radiografia panorâmica com a tomografia computadorizada de feixe cônico quando as raízes se encontram aquém do assoalho do seio maxilar / Abstract: The aim of this study was to assess what is the best image that offers better qualitative and quantitative information comparing the panoramic radiography with cone beam computed tomography to evaluate the relationship between the maxillary sinus and dental apices. For this, we used a convenience sample of 109 images of panoramic radiography and CBCT, from the same patients. Three calibrated observers evaluated a total of 1,875 apices, which were classified according to their topography relationship and measured when the apex was beyond/below the maxillary sinus floor in both imaging modalities. Agreement between the two imaging techniques was examined statistically. After an interval of 30 days, the assessment was repeated in 25% of the sample to statistically evaluate the intra-observer, the values found in the kappa test for qualitative assessment and the intraclass correlation coefficient for quantitative assessment represented a considerable - almost perfect correlation and excellent, respectively. To observe the correlation between the two images, the Kappa test for quality assessment showed a slight correlation to the palatal roots of the right first molars and second molars. When comparing the values of the quantitative assessment by intraclass correlation coefficient, there was poor agreement for the palatal roots of the left first molar and second molar, and also for the mesio-buccal roots of the right second molars and disto-buccal of the left second molars. It was concluded that there is a poor correlation between the two imaging modalities when the roots are in contact or when a projection of the roots was observed beyond the maxillary sinus floor in panoramic radiography, and a high concordance of panoramic radiography with cone beam computed tomography when the roots are below the maxillary sinus floor / Mestrado / Radiologia Odontologica / Mestra em Radiologia Odontológica

Indiana University-Purdue University Indianapolis (IUPUI) / Objectives: To investigate the effect of bulk-fill resin based composite materials on cuspal deflection in large slot mesio-occlusal-distal cavities (MOD) in premolar teeth. Methodology: Thirty-two sound maxillary premolar teeth with large slot MOD cavities were distributed to four groups (n=8). Three groups were restored with bulk-fill resin composite materials (Tetric EvoCeram, x-tra fil, and Sonic Fill, respectively) in a single increment. The conventional composite group, Filtek Z100, was used to restore the cavities in 2mm increments. Cusp deflection was recorded post irradiation using a Nikon measurescope UM-2 (Nikon, Tokyo, Japan), by measuring the changes in the bucco-palatal width of the premolar teeth at 5 minutes, 24 hours, and 48 hours after completion of the restoration. The cuspal deflection was obtained by recording the difference between the baseline measurements and the other measurements for each tooth. Results: Cuspal deflection was significantly higher in Conventional Composite than in Tetric EvoCeram Bulk Fill (p=0.0031), x-tra Fil Bulk (p=0.0029), and SonicFill Bulk (p=0.0002). There was no significant difference in cuspal deflection for Tetric EvoCeram Bulk, X-tra Fil Bulk, and SonicFill Bulk Composites. Conclusions: All the investigated bulk-fill resin composites exhibited cuspal deflection lower than conventional resin composite. One of the aims of research and studies on the resin composite materials is improving their clinical longevity, and simplifying their use. For that purpose bulk-fill materials are considered promising materials and further clinical studies should be conducted.

Este trabalho teve como objetivo avaliar cefalometricamente a estabilidade das medidas SNA, SNB, ANB, 1.NA, 1-NA, 1 .NB, 1 -NB, 1.ENP-ENA, IMPA e 1.1 a longo prazo, de pacientes tratados ortodonticamente com extrações dos quatro primeiros pré-molares e verificar, paralelamente a isto, se foram realizadas as compensações dentárias na mecânica ortodôntica e se estas foram preservadas cinco anos após o término do tratamento. Vinte e sete pacientes foram analisados no início (T1), no final (T2) e cinco anos após a finalização terapêutica (T3). No início do tratamento, a idade média era de 13 anos e 5 meses e todos os componentes apresentavam o ângulo ANB maior que 4º. Quatorze componentes apresentavam más oclusões Classe II, 1ª divisão de Angle, 12 componentes apresentavam más oclusões Classe I e 1, má oclusão Classe II, 2ª divisão. Os casos foram tratados com a técnica Edgewise. Nas três fases de estudo os cefalogramas laterais foram realizados manualmente, obtendo-se as oito grandezas angulares e as duas lineares. A análise estatística indutiva envolveu a análise de variância a um critério para identificar as alterações interfases no valor de cada variável estudada, e o teste de Tukey para indicar, especificamente, entre quais fases de estudo estaria ocorrendo diferenças estatisticamente significantes. Utilizou-se o coeficiente de correlação de Pearson, no afã de relacionar a medida cefal ométrica 1.1 com as demais medidas nas três fases de estudo. De acordo com os resultados obtidos, todas as medidas estudadas entre as fases inicial e final se alteraram significantemente refletindo a influência da mecânica ortodôntica sobre os movimentos dentários e entre as fases final e cinco anos após, todas as medidaspermaneceram estáveis. Obtiveram-se as compensações dentárias necessárias no final do tratamento ortodôntico e estas foram preservadas a longo prazo / The main objective of this study was to evaluate the long-term stability of the following cephalometric measurements: SNA, SNB, ANB, 1.NA, 1-NA, 1 .NB, 1 -NB, 1.ENP-ENA, IMPA, 1.1 . This analysis was carried out in orthodontically treated patients which had the four first pre-molars extracted. Alternatively, this study also determined the influence of the proposed treatment at the dento-basal arrangements by orthodontic mechanics and its preservation after five years of treatment completion. The sample of this study was comprised of twenty-seven patients that were assessed at the beginning (T1), at the end (T2) and five years later (T3). At the beginning of treatment the patients age averaged thirteen years and five months and all the subjects displayed an ANB angle over than 4 degrees. Among the studied sample, 14 subjects were classified as Angle Class II, Division 2 malocclusion, 12 subjects displayed Angle Class I, and 1 Angle Classe II, Division 2. All the subjects were orthodontically treated by means of edgewise appliances. During all the three phases of the study the radiological data were obtained through lateral cephalograms, which were performed manually, depicted eight angular and two linear measurements. The statistical analysis in which the data were processed included one way analysis of variance in order to identify the changes between the phases related to each studied measurement. As an adjunctive method, the Tukey test was conducted to indicate in which phases of the proposed study the statistically significant changes were occurring. The Pearson Product Moment Correlation was recorded to relate the 1.1 cephalometric measurements with all the remaining measurements obtained throughout the three phases of the study. According to the obtained results, all the studied measurements, between phases T1 and T2, significantly changed reflecting the influence of orthodontic mechanics on the dental movement. Between the T2 and T3 phases, all the measurements remained stable. By the end of the orthodontic treatment all the necessaries dental arrangements were performed and preserved in a long-term fashion.

Submitted by Rosivalda Pereira (mrs.pereira@ufma.br) on 2017-05-10T20:30:44Z No. of bitstreams: 1 CintiaRosalem.pdf: 518745 bytes, checksum: cb4beeb211cf4111067812984624770a (MD5) / Made available in DSpace on 2017-05-10T20:30:44Z (GMT). No. of bitstreams: 1 CintiaRosalem.pdf: 518745 bytes, checksum: cb4beeb211cf4111067812984624770a (MD5) Previous issue date: 2015-02-27 / Fundação de Amparo à Pesquisa e ao Desenvolvimento Científico e Tecnológico do Maranhão (FAPEMA) / Introduction: The root concavities may influence the dental treatment. Variations in root morphology are suggested as the main cause of perforations and other types of failures. The decrease in dentin thickness in the wall of the root canal in teeth subjected to endodontic treatment can be aggravated by procedures such as scaling and root planing and preparation for intracanal posts, especially in areas where the concavity is present. Objective: To evaluate the influence of root concavity mesial on the thickness and volume of dentin of maxillary first premolars before and after endodontic instrumentation and scaling and root planing. Methods: Twenty-seven firts premolars were analyzed for the presence of the proximal concavity. The teeth were then evaluated using the method of computed microtomography (micro-CT), where the thickness and the volume of dentin was examined. The teeth were scanned again after endodontic instrumentation and scaling and root planing. The data were submitted to descriptive statistical analysis. To evaluate the dentin thickness was used t test for paired samples and to evaluate the dentin volume, the Wilcoxon test (p <0.05). Results: The root concavities were present in all mesial surfaces of teeth examined. The dentin thickness in the region of the concavities decreased in millimeters, of 1.81 ± 0.25 to 1.55 ± 0.26 (p <0.001) and decreased dentin volume in cubic millimeters of 148.37 ± 43 53 to 140.36 ± 37.09 (p <0.001) after endodontic instruments and scaling and root planing. Conclusion: It can be concluded that the root concavities were present in 100% of the analyzed teeth. The dentin thickness in the region of the concavities decreased considerably after endodontic instruments and scaling and root planing, and the volume of dentin at the cervical third of the root also reduced after the treatments. / Introdução: As concavidades radiculares podem ter influência no tratamento odontológico. Variações na morfologia radicular são sugeridas como a principal causa de perfurações e outros tipos de falhas. A diminuição da espessura dentinária na parede do canal radicular, em dentes submetidos a tratamentos endodônticos, pode ser agravada por procedimentos como raspagem e alisamento radicular e preparos para pinos intrarradiculares, especialmente em áreas onde a concavidade está presente. Objetivo: avaliar a influência da concavidade radicular da face mesial dos primeiros pré-molares superiores na espessura e no volume de dentina antes e após instrumentação endodôntica e raspagem e alisamento radicular. Métodos: Vinte e sete primeiros pré-molares superiores foram analisados quanto à presença de concavidade proximal. Os dentes foram então avaliados, através do método da microtomografia computadorizada (Micro-CT), onde foi analisada a espessura e o volume de dentina. Os dentes foram novamente digitalizados após instrumentação endodôntica e raspagem e alisamento radicular. Os dados foram submetidos à análise estatística descritiva. Para avaliação da espessura dentinária foi utilizado o teste t para amostra pareadas e para avaliação do volume dentinário, o teste de Wilcoxon (p<0,05). Resultados: As concavidades radiculares estavam presentes em todas as faces mesiais dos dentes avaliados. A espessura de dentina na região da concavidade diminuiu, em milímetros, de 1,81±0,25 para 1,55±0,26 (p<0,001) e o volume dentinário diminuiu, em milímetros cúbicos, de 148,37±43,53 para 140,36±37,09 (p<0,001) após a instrumentação endodôntica e raspagem e alisamento radicular. Conclusão: Pode-se concluir que as concavidades radiculares estiveram presentes em 100% dos dentes analisados. A espessura de dentina na região da concavidade diminuiu consideravelmente após a instrumentação endodôntica e raspagem e alisamento radicular, assim como o volume de dentina no terço cervical da raiz também diminuiu após os tratamentos realizados.

Este trabalho teve como objetivo avaliar cefalometricamente a estabilidade das medidas SNA, SNB, ANB, 1.NA, 1-NA, 1 .NB, 1 -NB, 1.ENP-ENA, IMPA e 1.1 a longo prazo, de pacientes tratados ortodonticamente com extrações dos quatro primeiros pré-molares e verificar, paralelamente a isto, se foram realizadas as compensações dentárias na mecânica ortodôntica e se estas foram preservadas cinco anos após o término do tratamento. Vinte e sete pacientes foram analisados no início (T1), no final (T2) e cinco anos após a finalização terapêutica (T3). No início do tratamento, a idade média era de 13 anos e 5 meses e todos os componentes apresentavam o ângulo ANB maior que 4º. Quatorze componentes apresentavam más oclusões Classe II, 1ª divisão de Angle, 12 componentes apresentavam más oclusões Classe I e 1, má oclusão Classe II, 2ª divisão. Os casos foram tratados com a técnica Edgewise. Nas três fases de estudo os cefalogramas laterais foram realizados manualmente, obtendo-se as oito grandezas angulares e as duas lineares. A análise estatística indutiva envolveu a análise de variância a um critério para identificar as alterações interfases no valor de cada variável estudada, e o teste de Tukey para indicar, especificamente, entre quais fases de estudo estaria ocorrendo diferenças estatisticamente significantes. Utilizou-se o coeficiente de correlação de Pearson, no afã de relacionar a medida cefal ométrica 1.1 com as demais medidas nas três fases de estudo. De acordo com os resultados obtidos, todas as medidas estudadas entre as fases inicial e final se alteraram significantemente refletindo a influência da mecânica ortodôntica sobre os movimentos dentários e entre as fases final e cinco anos após, todas as medidaspermaneceram estáveis. Obtiveram-se as compensações dentárias necessárias no final do tratamento ortodôntico e estas foram preservadas a longo prazo / The main objective of this study was to evaluate the long-term stability of the following cephalometric measurements: SNA, SNB, ANB, 1.NA, 1-NA, 1 .NB, 1 -NB, 1.ENP-ENA, IMPA, 1.1 . This analysis was carried out in orthodontically treated patients which had the four first pre-molars extracted. Alternatively, this study also determined the influence of the proposed treatment at the dento-basal arrangements by orthodontic mechanics and its preservation after five years of treatment completion. The sample of this study was comprised of twenty-seven patients that were assessed at the beginning (T1), at the end (T2) and five years later (T3). At the beginning of treatment the patients age averaged thirteen years and five months and all the subjects displayed an ANB angle over than 4 degrees. Among the studied sample, 14 subjects were classified as Angle Class II, Division 2 malocclusion, 12 subjects displayed Angle Class I, and 1 Angle Classe II, Division 2. All the subjects were orthodontically treated by means of edgewise appliances. During all the three phases of the study the radiological data were obtained through lateral cephalograms, which were performed manually, depicted eight angular and two linear measurements. The statistical analysis in which the data were processed included one way analysis of variance in order to identify the changes between the phases related to each studied measurement. As an adjunctive method, the Tukey test was conducted to indicate in which phases of the proposed study the statistically significant changes were occurring. The Pearson Product Moment Correlation was recorded to relate the 1.1 cephalometric measurements with all the remaining measurements obtained throughout the three phases of the study. According to the obtained results, all the studied measurements, between phases T1 and T2, significantly changed reflecting the influence of orthodontic mechanics on the dental movement. Between the T2 and T3 phases, all the measurements remained stable. By the end of the orthodontic treatment all the necessaries dental arrangements were performed and preserved in a long-term fashion.

A normal aortic valve has three leaflets; however, 1- 2% of children are born with an aortic valve with two leaflets, referred to as congenital bicuspid aortic valves (BAV). Recent in vivo studies have shown that flow development past the bicuspid valves into the ascending aorta is markedly different from that past the normal tri-leaflet aortic valve. This difference may lead to the bicuspid valve having a higher rate of ascending aortic root dissection, a pathology that can potentially result in fatality. Using computational fluid dynamics we aim to evaluate the alterations in flow development in the ascending aorta with BAV compared to healthy tri-leaflet valves (TAV) and relate the alterations in flow-induced stresses with higher incidences of aortic dissection in patients with BAV. Simplified models based on the geometry and dimensions from published literature were developed. The preliminary results show that there is a difference in flow development between the BAV and the tri-leaflet valve. This is visible by the differences in wall shear stress and dynamic pressure distribution in the ascending aorta. The conclusion drawn from this is that there are marked differences in the ascending aortic flow development with BAV compared to that with TAV which may lead to dissection of the aortic arch.