Thesis (M.S.)--University of Michigan, 1986.

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

Thesis (M. S.)--Mechanical Engineering, Georgia Institute of Technology, 2010. / Committee Chair: Guldberg, Robert; Committee Member: McDevitt, Todd; Committee Member: Zamir, Evan. Part of the SMARTech Electronic Thesis and Dissertation Collection.

Made available in DSpace on 2014-06-11T19:31:07Z (GMT). No. of bitstreams: 0 Previous issue date: 2011-08-22Bitstream added on 2014-06-13T19:40:59Z : No. of bitstreams: 1 homsi_n_dr_araca.pdf: 690157 bytes, checksum: 4f4e024d5301db266278d9736fbf0050 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Proposição: A proposta deste estudo foi avaliar por análise histométrica a resposta tecidual óssea de enxerto autógeno coletado por piezocirurgia para o preenchimento de defeitos nas porções cervicais de implantes instalados em tíbias de coelhos. Métodos: Foram instalados 26 implantes em 13 tíbias de coelho, após a estabilidade inicial foram realizados defeitos cervicais por trefinagem, em um grupo foi mantido apenas o coágulo como preenchimento e em outro grupo o defeito foi preenchido por osso autógeno coletado por equipamento piezoelétrico, os animais foram sacrificados após 15 e 30 dias, a análise histométrica das interfaces implante-osso foram realizadas pelo software Image Lab. Resultados: Foi analisado o percentual de extensão linear de contato entre tecido ósseo e implante, a média percentual obtida de contato entre tecido ósseo neoformado e implante foram estabelecidas como médias da área de osso neoformado entre as espiras e contato osso-implante (BIC). Os resultados obtidos foram: no controle de 15 dias, o percentual entre as espiras foi de 65,2% e entre as espiras e contato osso-implante (BIC) de 88,7%. No controle de 30 dias o contato entre as espiras foi na ordem de 65,2% e entre as espiras e contato osso-implante (BIC) de 73,2%. No grupo de enxerto de 15 dias, o osso formado entre as espiras foi de 69,3% e entre as espiras e contato osso-implante (BIC) em 81%, no grupo enxerto 30 dias o osso formado entre as espiras foi de 91,47% e entre as espiras e contato ossoimplante (BIC) 91,56%. Conclusão: o enxerto ósseo autógeno particulado obtido por piezocirurgia apresenta melhor resultado que o coágulo sanguíneo no osso neoformado entre as espiras e no contato osso-implante / Purpose: The purpose of this study was to evaluate by histometric analysis the outcome of autogenous bone collected through piezo surgery equipment in filling cervical portion defects around implants placed in rabbits tibias. Materials and Methods: Twenty-six implants were installed in 13 rabbits tibias, after initial primary stability, cervical defects were carried out by the use of a trephina, in one group the cloth was maintained as the defect filling and in another group the defect was filled by autogenous bone collected through piezo surgery equipment, the animals were sacrificed after 15 and 30 days, the histometric analysis of the implant-bone interfaces were carried out by the use of Image Lab software. Results: The lineal stretch percentage of contact between bone and implant was analyzed, the average percentage obtained in the contact between the newly formed bone and the implant was established as the average area of the newly formed bone in the space between the spires and the bone-implant contact (BIC). The results obtained were: in the 15-days control group, the percentage of bone formation between the spires was of 65.2% and between the spires and boneimplant contact (BIC) was of 88.7%. In the 30-days control group the contact between the spires was of 65.2% and between the spires and bone-implant contact (BIC) of 73.2%. In the 15-days control grafted group, the formed bone between the spires was of 69.3% and between the spires and bone-implant contact (BIC) of 81%, in the 30-days control grafted group, the formed bone between the spires was of 91.47% and between the spires and bone-implant contact (BIC) of 91.56%. Conclusions: the autogenous bone collected through piezo surgery equipment showed better results than the blood clot regarding the newly formed bone between the spires and bone-implant contact (BIC)

Orientador: Jose Ricardo Albergaria Barbosa / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-10T12:50:20Z (GMT). No. of bitstreams: 1 Oliveira_GreisonRabelode_D.pdf: 14325422 bytes, checksum: 05b562621ec1f86114ab47c2c49114e6 (MD5) Previous issue date: 2008 / Resumo: A instalação de implantes na região posterior da maxila várias vezes é confrontada com processos alveolares reabsorvidos, resultantes de uma combinação da pneumatização do seio maxilar, dos efeitos da doença periodontal, e do processo de reabsorção óssea fisiológica resultante da falta de estímulo funcional que sucede as exodontias. O levantamento do assoalho do seio maxilar vem sendo praticado desde 1980 com o objetivo de aumentar a altura óssea nessa região, promovendo condições para uma reabilitação protética suportada por implantes. Recentemente alguns trabalhos relataram resultados favoráveis utilizando o coágulo sangüíneo no preenchimento do seio maxilar. Dessa forma, avaliamos através de uma análise clínica e radiográfica, a neoformação óssea no interior do seio maxilar após o levantamento do assoalho e preenchimento da cavidade apenas com coágulo sangüíneo local. Para isto foram selecionados 10 pacientes com edentulismo na região posterior da maxila, representando assim 10 seios maxilares. Após um período médio de 11,9 meses depois do levantamento do assoalho, apenas 3 seios maxilares apresentaram neoformação óssea que permitiu a instalação dos implantes. Contrariamente aos resultados favoráveis da análise radiográfica sugestivos de neoformação óssea, clinicamente observamos que a utilização do coágulo no levantamento do assoalho do seio maxilar não se mostrou efetiva neste estudo / Abstract: Implant placement in the posterior maxilla is frequently challenged by resorbed alveolar processes due to a combination of maxillary sinus pneumatization, the effects of periodontal disease and the physiological bone resorption following tooth extractions. The sinus floor augmentation surgery has been performed since 1980 with the purpose of increasing bone height in this region, allowing implant-supported prosthetic rehabilitation. Recently, a few studies have presented favorable results using blood clot for maxillary sinus filling. Therefore, we evaluated through clinical and radiographic analysis the neoformation of bone inside the maxillary sinus after sinus lifting and the filling of the cavity with local blood clot alone. Ten patients with posterior maxillary edentulism were selected, representing 10 maxillary sinuses. Following a mean period of 11.9 months after sinus floor augmentation, only 3 sinuses presented bone neoformation that allowed implant placement. Conversely to the favorable results observed in the radiographic analysis, the use of blood clot for sinus floor augmentation was not clinically effective in the present study / Doutorado / Cirurgia e Traumatologia Buco-Maxilo-Faciais / Doutor em Clínica Odontológica

Orientador: Roger William Fernandes Moreira / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-08T16:09:31Z (GMT). No. of bitstreams: 1 Sawazaki_Renato_M.pdf: 1407443 bytes, checksum: 22de8971b16885ec62214ad8fde67a9d (MD5) Previous issue date: 2007 / Resumo: O presente estudo tem por objetivo a avaliação dos tratamentos visando reconstrução dos maxilares com enxertos autógenos de crista ilíaca desenvolvidos na Faculdade de Odontologia de Piracicaba, Universidade de Campinas do período de primeiro de Janeiro de 2004 a trinta de junho de 2005. Foram avaliados 16 casos, nos quais se analisou dados extraídos da anamnese, exame físico e complementar, bem como indicação, planejamento, tratamento utilizado e proservação tanto da cirurgia para remoção de enxerto da crista ilíaca quanto da cirurgia para instalação de implantes. Um questionário foi usado para coletar dados relativos ao período pós-operatório da cirurgia da crista ilíaca, como dor, padrão de cicatrização, distúrbios sensoriais e motores, resolução do tratamento e seqüelas; e dados relativos à satisfação do paciente frente às dificuldades, sucessos e insucessos possíveis. A dor pós-operatória foi referida em 100% dos pacientes submetidos ao enxerto, 93,5% de distúrbio de marcha, 25% de queixa quanto à cicatriz e 12,5% de perda de enxerto. Os resultados sugerem, também, relação entre maior dor pós-operatória no sítio doador em pacientes com índices de massa corpórea acima do normal. Quanto à cirurgia de implantes foi constada falha precoce em 2,0% dos 98 implantes instalados. Assim, a reconstrução de maxilares é um procedimento seguro com altas taxas de sucesso devendo ser usada sempre que necessário / Abstract: The aim of the present study is to evaluate treatment outcomes for reconstructive surgery of the jaws with iliac crest as donnor site performed at Piracicaba Dental School, UNICAMP, between the begin of january 2004 and the end of june 2005. Sixteen cases were selected and data obtained from the clinical records were analysed. This data included medical history, physical examination, treatment indications and planning as well as follow up observations for the donnor site and dental implants installed in the grafted area. A questionnaire was applied to evaluate data relative to postoperative pain, healing pattern, motor and neurosensorial disturbances, treatment outcomes and overall satisfaction. Data analysis related to the graft procedure revealed postoperative pain in 100% of the patients, gait disturbances in 93.5%, visible scar in 25% and graft loss in 12.5%. Related to implant surgery, it was observed early loss in 2.0% of the 98 implants installed. The results also suggest a relationship between postoperative higher scores of pain in the donor site in elevated body mass indexes patients. Therefore, maxillary reconstruction is safe procedure with elevated success rates / Mestrado / Cirurgia e Traumatologia Buco-Maxilo-Faciais / Mestre em Clínica Odontológica

Abstract A new animal model was developed to evaluate the effect of bovine native bone morphogenetic protein (BMP) on the healing of segmental, critical-sized bone defects. Laboratory-bred adult beagle dogs were used in the study. A 2 cm corticoperiosteal defect was created using an oscillating saw in mid-ulna, and the defect was treated with bone grafts and implants fixed by an intramedullary Kirschner wire through predrilled holes in the middle of the implant. Plate and screw fixation was also used in some groups. Coral, hydroxyapatite and demineralized xenograft bone were placed in the defects with or without BMP. Autografts and allografts were used as controls. The BMP was extracted from bovine diaphyseal bone. The follow-up period was 36 weeks. Radiographs were taken at regular intervals during the follow-up period, and bone formation and bone union were evaluated. The radiographs were digitized, and callus was measured and CT scans obtained to define bone density. At the end of the study, the bones were harvested and tested mechanically in a torsion machine until failure. After mechanical testing, the bones were reconstructed and histological sections were made. With autograft and allograft bone grafts, healing was nearly complete. Hydroxyapatite and demineralized xenograft bone did not result in healing of the bone defect, while coral enhanced bone formation, but the healing was not comparable to autografts or allografts. Hydroxyapatite implants did not resorb during the 36 weeks of follow-up to enhance bone healing, and there was a fibrous capsule around the hydroxyapatite implants in histology. Xenograft bone was resorbed, and very little bone formation and extensive fibrosis were seen at the implant site. Coral was resorbed and gradually replaced by new bone, but did not heal the defect completely. With every implant, added BMP had a positive effect on healing as evaluated either radiographically, mechanically or histologically. Coral was the most optimal carrier material for BMP among the materials tested in this study. The animal model seems to be suitable for studying the healing of bone defects, as all the animals were physically active from the first postoperative day and did not seem to have problems with motion during the follow-up period. Intramedullary fixation lacks rotational stability, which may have a negative effect on healing. The bones fixed with a plate and screws showed better scores in radiographs and were mechanically stronger, although the study groups were too small to allow definitive conclusions. As a conclusion, none of the transplants or implants were equally efficient as cortical autograft in healing segmental ulnar defects. BMP did not enhance the poor capacity of hydroxyapatite and xenograft bone to heal the bone defect. According to the present findings, the composite implant consisting of coral and BMP seemed to be the best of the composite implants tested.

No description available.

OBJETIVO: Determinar a efetividade de manobras padronizadas de drenagem linfática manual (DLM) na redução do edema facial, na distância interincisal máxima ativa e no quadro álgico de pacientes submetidos à cirurgia de Enxerto Ósseo Alveolar (EOA). METODOLOGIA: Esta pesquisa analisou 51 indivíduos com fissura labiopalatina reparada, entre 10 e 15 anos de idade, submetidos ao EOA no Hospital de Reabilitação de Anomalias Craniofaciais-USP, divididos em 2 grupos, grupo tratamento (n=29, 12 homens e 17 mulheres) e grupo rotina (n= 22, 15 homens e 7 mulheres). No grupo tratamento foram aplicadas manobras de DLM padronizadas diferentemente daqueles do grupo rotina. Foram realizadas nos dois grupos avaliações do edema facial por meio das medidas da linha 1 (distância da base da asa nasal ao tragus) e linha 2 (distância da base da asa nasal à implantação inferior do pavilhão auricular), na hemiface operada nos períodos pré-operatório (Pré), segundo (2ºPO) e quarto pós-operatório (4ºPO). Também foram realizadas as medidas da distância interincisal máxima ativa nos mesmos períodos. A Escala Analógica da Dor (EAD) foi aplicada no 1º, 2º, 3º e 4º períodos pós-operatórios. Adicionalmente, no grupo tratamento, após a terapia de DLM, foram realizadas perguntas sobre dor, relaxamento e sono. RESULTADOS: Houve redução do edema facial no grupo tratamento do 2ºPO para o 4ºPO o que não ocorreu no grupo rotina. As medidas da distância interincisal apresentaram aumento entre o 2ºPO e 4ºPO nos dois grupos estudados. Na avaliação da EAD, o grupo tratamento mostrou ausência de dor no 3ºPO enquanto o grupo rotina somente no 4ºPO. No grupo tratamento, a totalidade dos indivíduos relataram que a dor diminuiu, e que se sentiram mais relaxados após a DLM, nos 3 períodos avaliados. Relataram também em muitos casos que a DLM teve efeito facilitador na indução ao sono durante a DLM. CONCLUSÕES: As manobras padronizadas de DLM aplicadas da maneira proposta produziram redução significante do edema facial, aumento da distância interincisal máxima ativa, redução do quadro álgico no grupo tratamento comparativamente ao grupo rotina. Esses dados reforçam a hipótese de que a DLM proposta foi efetiva contribuindo de maneira importante na recuperação do paciente submetido à cirurgia de EOA. / OBJECTIVE: To determine the effectiveness of standardized manual lymphatic drainage (MLD) maneuvers in reducing facial swelling, maximum interincisal active distance and pain of patients undergoing surgery for Alveolar Bone Grafting (ABG). METHODS: This study examined 51 individuals with repaired cleft lip and palate, aged 10 to 15 years old, who underwent ABG at the Hospital for Rehabilitation of Craniofacial Anomalies- USP, divided into two groups: treatment group (n = 29, 12 men and 17 women) and routine group (n = 22, 15 men and 7 women). In the treatment group MLD standardized maneuvers were performed differently from those of the group routine. In both groups evaluation of facial swelling was performed by measuring the distance from the ala nasi to the tragus (line 1) and the distance from the ala nasi to the inferior portion of the ear auricle (line 2), in the operated side, preoperatively, and at the second and the fourth postoperative (PO) day. The maximum active interincisal distance was measured during the same periods. The Pain Analog Scale (PAS) was applied at the first, second, third and fourth days after ABG. Additionally, patients from the treatment group, were asked about pain, relaxation and sleep after MLD therapy. RESULTS: There was a reduction of facial edema in the treatment group from the 2nd to 4th PO what was not observed the routine group. Interincisal distance increased between the 2nd and 4th PO in both groups. PAS evaluation has shown that patients from the treatment group present no pain already at 3rd PO. In the routine group this occurred only at 4th PO. All the subjects from treatment group reported decrease of pain, and patients reported felt more relaxed after the MLD, at the three postoperative evaluated. Many patients reported that MLD had a facilitative effect on inducing sleep during MLD. CONCLUSIONS: The standardized MLD maneuvers applied in the proposed manner produced significant reduction of facial swelling, increase of the maximum active interincisal distance, reduction of the pain in the treatment group as compared to the routine group.These Abstract data reinforce the hypothesis that the proposed MLD is a effective procedure for the recovery of the patients undergoing ABG surgery.

Objetivo: O propósito deste estudo é avaliar a regeneração óssea nos defeitos alveolares congênitos com proteína morfogenética óssea (rhBMP-2) em membrana de colágeno reabsorvível. Material e Métodos: Vinte e quatro pacientes com fissura labiopalatina completa unilateral, em momento ideal, foram distribuídos ao acaso entre os grupos controle (porção medular de ilíaco) e teste (rhBMP-2 em membrana de colágeno absorvível). Foram avaliados em 6 meses e 1 ano de pós-operatório por meio de radiografias periapicais e tomografias computadorizadas pela escala de Chelsea. Resultados: Encontraram-se índices de sucesso quanto à altura do septo ósseo semelhantes entre os grupos: em 6 meses, na análise radiográfica, 81,82% no controle e 91,67% no teste; em 1ano, 83,33% no controle e 100% no teste; na análise tomográfica, observaram-se 70% no controle e 91,67% no teste em 6 meses, 75% no controle e 100% no teste em 1 ano. Na análise volumétrica, os valores encontrados foram 45,34% de preenchimento ósseo da fissura no grupo controle aos 6 meses e 40,63% no teste, 53,33% no controle e 53,1% no teste em 1 ano. Não houve diferença estatisticamente significante. Conclusão: A rhBMP-2 em membrana reabsorvível de colágeno produziu resultados semelhantes ao enxerto autógeno de medula de crista ilíaca ao reparar defeitos alveolares de fissuras labiopalatinas completas. / Objective: The purpose of this study is to assess the bony regeneration of alveolar clefts using bone morphogenetic protein (rhBMP-2) in a collagen sponge carrier. Material and Methods: Twenty four patients with unilateral complete cleft lip and palate, in the very best moment, were randomly assigned to groups control (iliac crest cancellous bone) and test (rhBMP-2 in an absorbable collagen sponge). They were evaluated 6 months and 1 year postoperative with periapical radiographs and computed tomographs using Chelsea scale. Results: For control group, radiographic examination revealed success index for bone height 81,82% 6 months and 83,33% 1 year postoperative; for test group, findings were 91,67% first control and 100% 1 year. Computed tomograph revealed 70% 6 months and 75% 1 year for control group, 91,67% first control and 100% 1 year for bone height test group. Volume ratios were 45,34% bone filling 6 months and 53,33% 1 year for control group and 40,63% 6 months and 53,1% 1 year for test. There was no statistical significance. Conclusion: rhBMP-2 in a collagen sponge carrier induced bony regeneration close to that from iliac crest cancellous bone to repair complete alveolar clefts.