Made available in DSpace on 2014-06-11T19:24:37Z (GMT). No. of bitstreams: 0 Previous issue date: 2004-04-19Bitstream added on 2014-06-13T19:52:07Z : No. of bitstreams: 1 hussne_rp_me_arafo.pdf: 933223 bytes, checksum: eec4a12df3f91664475c69cb40e475cd (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / As fissuras de lábio e/ou palato são más-formações congênitas que acarretam como conseqüência uma série de alterações: comprometimento da estética, fala e da posição dos dentes. O cirurgião dentista tem um papel fundamental no tratamento do paciente fissurado, pois a maioria deles necessita de uma reabilitação oral caracterizada pela atuação de especialistas de várias áreas como ortodontia, dentística, endodontia, periodontia e prótese. O objetivo deste estudo foi conhecer a demanda de atendimento endodôntico em pacientes fissurados de lábio e/ou palato cadastrados no Hospital de Reabilitação de Anomalias Craniofaciais (HRAC). Buscamos estudar a associação entre o tipo de fissura oral e o comprometimento endodôntico, quantificar as causas do tratamento endodôntico, bem como o prognóstico desses dentes. Foram avaliados 671 prontuários de pacientes com idades entre 7 e 65 anos, que foram atendidos no Setor de Endodontia do HRAC, totalizando 1377 dentes que receberam tratamento endodôntico radical. Após a coleta de dados nos prontuários, os mesmos foram lançados em uma tabela no computador e submetidos à análise estatística. Os resultados demonstraram que a maior parte dos pacientes atendidos era do gênero masculino, proveniente da região sudeste do Brasil. O tipo de fissura mais comum foi a transforame incisivo. O tratamento endodôntico mais realizado foi a necropulpectomia, tendo como causas mais freqüentes a cárie dentária e a finalidade protética. Poucos foram os dentes extraídos pós tratamento endodôntico, sendo a cárie a causa mais comum para as exodontias. Concluímos, portanto, que a necessidade de tratamento endodôntico está diretamente relacionada à alta incidência de cárie nesses pacientes. A grande porcentagem de dentes mantidos demonstra que o prognóstico desses dentes é favorável... . / Cleft lip and/or palate are congenital malformations that bring about several alterations, such as impairment in esthetics, speech and tooth positioning. The dental professional plays a fundamental role in the treatment of patients with clefts, since they need an oral rehabilitation characterized by the collaborative work of specialists of several fields such as Orthodontics, Restorative Dentistry, Endodontics, Periodontics and Prosthodontics. The aim of this study was to investigate the demand of endodontic treatment in patients with cleft lip and/or palate attending the Hospital for Rehabilitation of Craniofacial Anomalies (HRAC). An attempt was made to assess the association between the type of cleft and the endodontic disturbances, quantify the causes of endodontic treatment, as well as the prognosis of these teeth. A total of 671 records of patients aged 7 to 65 years assisted at the Sector of Endodontics of the HRAC were evaluated, adding up to 1,377 teeth submitted to endodontic treatment. Data were collected from the records, entered in a data sheet in the computer and submitted to statistical analysis. The results demonstrated that most patients assisted were of male gender and from Southeast Brazil; the most common type of cleft was the complete cleft lip and palate; the endodontic treatment most frequently provided was non-vital pulp therapy. Few teeth were extracted after the endodontic treatment, and caries was the most common reason for such extractions. Therefore, it was concluded that the need of endodontic treatment is directly related to the high caries incidence among these patients. The large percentage of teeth maintained demonstrates that the prognosis of these teeth is favorable, and that both the endodontic planning and the collaborative planning have been effective.

Orientador: Renato de Toledo Leonardo / Banca: Idomeo Bonetti Filho / Banca: Celso Kenji Nishiyama / Resumo: As fissuras de lábio e/ou palato são más-formações congênitas que acarretam como conseqüência uma série de alterações: comprometimento da estética, fala e da posição dos dentes. O cirurgião dentista tem um papel fundamental no tratamento do paciente fissurado, pois a maioria deles necessita de uma reabilitação oral caracterizada pela atuação de especialistas de várias áreas como ortodontia, dentística, endodontia, periodontia e prótese. O objetivo deste estudo foi conhecer a demanda de atendimento endodôntico em pacientes fissurados de lábio e/ou palato cadastrados no Hospital de Reabilitação de Anomalias Craniofaciais (HRAC). Buscamos estudar a associação entre o tipo de fissura oral e o comprometimento endodôntico, quantificar as causas do tratamento endodôntico, bem como o prognóstico desses dentes. Foram avaliados 671 prontuários de pacientes com idades entre 7 e 65 anos, que foram atendidos no Setor de Endodontia do HRAC, totalizando 1377 dentes que receberam tratamento endodôntico radical. Após a coleta de dados nos prontuários, os mesmos foram lançados em uma tabela no computador e submetidos à análise estatística. Os resultados demonstraram que a maior parte dos pacientes atendidos era do gênero masculino, proveniente da região sudeste do Brasil. O tipo de fissura mais comum foi a transforame incisivo. O tratamento endodôntico mais realizado foi a necropulpectomia, tendo como causas mais freqüentes a cárie dentária e a finalidade protética. Poucos foram os dentes extraídos pós tratamento endodôntico, sendo a cárie a causa mais comum para as exodontias. Concluímos, portanto, que a necessidade de tratamento endodôntico está diretamente relacionada à alta incidência de cárie nesses pacientes. A grande porcentagem de dentes mantidos demonstra que o prognóstico desses dentes é favorável... (Resumo completo, clicar acesso eletrônico abaixo). / Abstract: Cleft lip and/or palate are congenital malformations that bring about several alterations, such as impairment in esthetics, speech and tooth positioning. The dental professional plays a fundamental role in the treatment of patients with clefts, since they need an oral rehabilitation characterized by the collaborative work of specialists of several fields such as Orthodontics, Restorative Dentistry, Endodontics, Periodontics and Prosthodontics. The aim of this study was to investigate the demand of endodontic treatment in patients with cleft lip and/or palate attending the Hospital for Rehabilitation of Craniofacial Anomalies (HRAC). An attempt was made to assess the association between the type of cleft and the endodontic disturbances, quantify the causes of endodontic treatment, as well as the prognosis of these teeth. A total of 671 records of patients aged 7 to 65 years assisted at the Sector of Endodontics of the HRAC were evaluated, adding up to 1,377 teeth submitted to endodontic treatment. Data were collected from the records, entered in a data sheet in the computer and submitted to statistical analysis. The results demonstrated that most patients assisted were of male gender and from Southeast Brazil; the most common type of cleft was the complete cleft lip and palate; the endodontic treatment most frequently provided was non-vital pulp therapy. Few teeth were extracted after the endodontic treatment, and caries was the most common reason for such extractions. Therefore, it was concluded that the need of endodontic treatment is directly related to the high caries incidence among these patients. The large percentage of teeth maintained demonstrates that the prognosis of these teeth is favorable, and that both the endodontic planning and the collaborative planning have been effective. / Mestre

Orientador: Dagmar de Paula Queluz / Dissertação (mestrado profissional) - Universidade Estadual de Campinas, Faculdade de Odontologia / Made available in DSpace on 2018-08-05T09:48:38Z (GMT). No. of bitstreams: 1 Nunes_LuizMauricioNogueira_M.pdf: 752283 bytes, checksum: 66bb5395cf7afc984cc85b40a03e0598 (MD5) Previous issue date: 2005 / Resumo: O objetivo deste estudo foi determinar a prevalência de fissuras de lábio e/ou palato no município de Campos dos Goytacazes-RJ, em crianças nascidas entre 01/01/1999 a 31/12/2004, e pesquisar a notificação da ocorrência da malformação na Declaração de Nascido Vivo (DNV) e no Sistema de Informações sobre Nascidos Vivos (SINASC), através de pesquisa no campo 34, destinado à notificação de malformação congênita. Foram considerados a faixa etária, tipo de fissura, gênero e raça da criança, além do estado civil, grau de escolaridade e procedência da mãe do portador na época do parto. Deste modo, foram verificados os prontuários de pacientes inscritos em serviços de referência em tratamento de anomalias craniofaciais, das cidades de Campos dos Goytacazes(RJ), Rio de Janeiro(RJ) e Bauru(SP), com o objetivo de selecionar os nascidos e/ou domiciliados no município de Campos dos Goytacazes, no período de interesse. Após seleção inicial, foi realizada busca no SINASC, definindo o universo do estudo, a saber: nascidos vivos entre 1999 e 2004, cujas mães eram residentes em Campos dos Goytacazes. Neste período, o número de nascidos no município, por residência da mãe, foi de 46.707, dos quais 63 possuíam algum tipo de fissura de lábio e/ou palato, representando uma prevalência de 1,35 casos por 1000 nascidos vivos. A análise dos dados revelou que 55,6% dos pacientes eram do gênero masculino. O tipo de fissura mais encontrado foi o pós-forame incisivo (34,9%), seguido do transforame (31,7%) e do pré-forame incisivo (30,2%). Embora a raça branca tenha representado 61,3% dos indivíduos estudados, o percentual de casos por raça não diferiu estatisticamente em relação à distribuição de nascidos na população. A maior parte das mães era solteira ou separada, possuindo como característica o baixo grau de escolaridade. Em relação à notificação de malformação, diante da análise do preenchimento do campo 34, verificou-se que, tanto a DNV, como, principalmente, o SINASC se mostraram ineficientes no registro das fissuras labiopalatais, em decorrência de falhas no preenchimento das mesmas e, principalmente, pela ausência do preenchimento do código da CID-10 na DNV / Abstract: The purpose of the present study was to determine the prevalence of oral clefts in the city of Campos dos Goytacazes-RJ/BR, in children born from January 01, 1999 to December 31, 2004, and to research the notification of the occurrence of malformation in the Live Births Declaration (LBD) and in the Information System on Live Births (ISLB), through research in the field 34 destined to the notification of congenital malformation. There has been considered the age group, clefts type, gender and the race of the child, as well as the marital status, education degree and the origin of the child¿s mother at the time of the birth. This way, the patients' handbooks enrolled in reference services in treatment of craniofacial anomalies in the cities of Campos dos Goytacazes(RJ), Rio de Janeiro(RJ) and Bauru(SP), were verified with the purpose of selecting the ones whose birth and/or residence was in the city of Campos dos Goytacazes, within the period of interest. After the initial selection, a search in ISLB was accomplished to define the universe of the study, that was: finding the children who were born alive between 1999 and 2004 whose mothers were resident in Campos dos Goytacazes. In this period, using as a reference the residence of the mother, the number of children born in the city was of 46707, of which 63 possessed cleft lip with or without cleft palate, representing a prevalence of 1.35 cases in every 1000 live births. The analysis of the data revealed that 55.6% of the patients were male; the more found cleft type was of isolated cleft palate (34.9%), followed by the cleft lip and palate (31.7%) and the cleft lip (30.2%); the white race represented 61.3% of the cases but the percentage of cases within each race didn¿t differ statistically in relation to the distribution of the births in the population; most of the mothers were single or divorced, having as a characteristic the low education degree. As regarding to the malformation notification, the analysis of the registration field 34 displayed that, the LBD and the ISLB were shown inefficient in the notification of the oral clefts, due to mistakes in the completion of the same ones and, mainly, for the absence of the completion of the International Classification of Diseases (ICD-10) code in LBD / Mestrado / Mestre Profissional em Odontologia em Saúde Coletiva

Objetivo: Desenvolver um instrumento de avaliação do desempenho psicossocial para pacientes com fissura labiopalatina. Modelo: O estudo engloba a pesquisa de campo sobre os aspectos psicossociais de pessoas com fissura labiopalatina. Local de Execução: Hospital de Reabilitação de Anomalias Craniofaciais (HRAC) USP. Participantes: Profissionais da Psicologia e do Serviço Social e demais membros da equipe de reabilitação do HRAC. Análise de prontuários do HRAC, Hospitais de alta complexidade do Brasil e exterior. Variáveis: relacionamento familiar, escolaridade, ocupação, relacionamento social, ajustamento emocional, satisfação com o tratamento e situação socioeconômica e saúde. Resultados: o instrumento proposto de avaliação do desempenho psicossocial foi elaborado, contando com 40 questões divididas em quatro domínios: físico, psicológico, relações sociais e meio ambiente. Conclusões: A partir da pesquisa bibliográfica, documental e de campo e da análise dos aspectos psicossociais relevantes, foi possível desenvolver o instrumento de avaliação do desempenho psicossocial para pacientes com fissura labiopalatina. / Objective: To develop an instrument for evaluation of the psychosocial performance of patients with cleft lip and palate. Design: Field study on the psychosocial aspects of individuals with cleft lip and palate. Setting: Reference cleft center Hospital for Rehabilitation of Craniofacial Anomalies (HRAC) at University of São Paulo (USP). Participants: Psychologists, social workers and other members of the rehabilitation team of HRAC. Analysis of patients records of HRAC, high complexity hospitals in Brazil and abroad. Variables: Family relationship, educational level, occupation, social relationships, emotional adjustment, satisfaction with treatment, socioeconomic status and health. Results: The proposed instrument for evaluation of the psychosocial performance was developed with 40 questions divided in four domains: physical, psychological, social relations and environment. Conclusions: Based on the literature review, documental and field study and analysis of the relevant psychosocial aspects, it was possible to develop the instrument for evaluation of the psychosocial performance of patients with cleft lip and palate.

Objetivos: determinar o número de indivíduos com fissura labiopalatina não sindrômica (FLPNS) no núcleo familiar; determinar a presença de consanguinidade parental na presente casuística; descrever as eventuais anomalias menores observadas na amostra; e, estimar os riscos de recorrência familial para probando/filhos, nos diferentes grupos de fissura labiopalatina. Metodologia: O estudo retrospectivo e prospectivo constituiu uma amostra de 841 indivíduos, cadastrados no HRAC/USP. Os critérios mínimos para a inclusão foram: presença de FLPNS e existência de filhos (exceto os adotados) dos probandos. A amostra foi dividida em dois grupos, Grupo I: probandos com fissura de lábio com ou sem fissura de palato (FL+/-FP) e Grupo II: probandos com fissura de palato (FP). Resultados: Do total de 841 indivíduos, 660 (237M e 423F) constituíram o Grupo I e 181 (41M e 140F), o Grupo II. Consanguinidade parental foi observada em 2,2% dos indivíduos do Grupo I e, 0,6% do Grupo II. No Grupo I, 12,3% dos indivíduos apresentaram até duas anomalias menores e, no Grupo II, 21,0%; sendo hipoplasia de face média a anomalia menor mais frequente, em ambos os grupos. A frequência de recorrência familial (pai, mãe, irmãos do propósito), no Grupo I, foi de 14,0%, enquanto que, no Grupo II, de 11,0%. Já, em relação ao cálculo dos riscos de recorrência, determinou-se risco de 5,3% IC (Intervalo de confiança) a 95% (4,2% - 6,7%) para propósito(a)/filho(a) e de 4,3% IC 95% (2,6% - 6,8%) para o Grupo I e II, respectivamente, considerando-se risco para um casal com um dos progenitores afetados, independente do gênero do probando para o primeiro filho(a) afetado(a). Por outro lado, considerando-se o gênero dos probandos, no Grupo I, obteve-se risco de recorrência de 2,7% IC 95% (1,6% - 4,0%) para filho(a) de probando feminino e risco de recorrência de 6,2% com IC 95% (4,3% - 8,7%) para filho(a) de probando masculino e, no Grupo II observou-se risco de recorrência de 4,5% IC 95% (2,4% - 7,4%) para o primeiro filho(a) afetado(a) de probando feminino e risco de 3,9% com IC 95% (1,0% - 9,7%) para o primeiro filho(a) afetado(a) de probando masculino. Conclusões: O presente estudo mostrou que o valor do risco de recorrência encontrado no grupo de indivíduos com FL+/-FP foi similar ao do grupo com FP, sem identificação do gênero; o risco de recorrência probando/filho, no Grupo I, foi duas vezes maior para os probandos do gênero masculino do que para o feminino e, no Grupo II, os riscos de recorrência foram similares para probandos de ambos os gêneros. / Purposes: to determine the number of individuals with nonsyndromic cleft lip and palate (NSCLP) within the familial nucleus; to determine the presence of parental consanguinity in the sample; to describe the possible minor anomalies observed in the sample; and to estimate the recurrence risks for the proband\'s children in the different groups of cleft lip and palate. Methods: The retrospective and prospective study was based on a sample of 841 individuals, registered at the Hospital de Reabilitação de Anomalias Craniofaciais, Universidade de São Paulo (HRAC/USP). The minimum criteria used for inclusion were: presence of NSCLP and the existence of biological children of the proband\'s. The sample was divided into two groups, Group I: proband\'s with cleft lip with or without cleft palate (CL+/-CP) and Group II: proband\'s with cleft palate (CP). Results: From the total of 841 individuals, 660 (237M and 423F) constituted Group I and 181 (41M and 140F), Group II. Parental consanguinity was observed in 2.2% of the individuals in Group I and in 0.6% in Group II. In Group I 12.3% of the individuals presented up to two minor anomalies and in Group II 21.0%; mid-face hypoplasia was the most frequent minor anomaly observed in both groups. The frequency of familial cases in Group I was 14.0%, while in Group II it was 11%. By estimation of the recurrence risk, a risk of 5.3% SR (statistical reliability) 95% (4.2% - 6.7%) and of 4.3% SR 95% (2.6% - 6.8%) was determined for the proband\'s child in Group I and II respectively, with one affected parent, independent of the proband\'s gender. On the other hand, considering the proband\'s gender, in Group I a recurrence risk of 2.7% SR 95% (1.6% - 4.0%) was obtained for the child of a female proband and a recurrence risk of 6,2% SR 95% (4.3% - 8.7%) for the child of a male probando. In Group II a recurrence risk of 4.5% SR 95% (2.4% - 7.4%) was observed for a female proband and a risk of 3.9% SR 95% (1.1% - 9.7%) for a male proband. Conclusion: The present study showed that the recurrence risk in the CL+/-CP group was similar when compared to the group with CP, without taking into account the gender of the proband; the recurrence risk, in Group I was twice as high a male proband as for a female proband, while in Group II the recurrence risk was similar for the proband\'s of either gender.

Abstract The aim of this study was to define distinct craniofacial features in subjects with nonsyndromic cleft lip and palate (CLP) and in subjects with Turner syndrome (TS), and to evaluate the resemblance of these features among their family members. This might help in elucidating if there is a parental contribution to possible predisposing craniofacial features in cleft subjects and to the severity of certain distinct craniofacial features in subjects with X chromosome monosomy. The study population consisted of 29 Costa Rican CLP families including unaffected parents and siblings, and of 71 TS (45,X) subjects and members of their families. Based on lateral and frontal cephalometric analyses, cleft family members were characterized by reduced cranial height and head width, greater interorbital and nasal cavity widths, shorter anterior cranial base and palatal lengths, and shorter total face height compared to control values. With respect to these distinct craniofacial features, there were statistically significant associations in anterior cranial base and palatal length, and head, forehead and outer interorbital width measurements between parents and their children with CLP. The sidedness of the cleft in affected children was related to the asymmetry of the nasal cavity width in their parents. The distinct craniofacial features of the TS subjects, such as short clivus, retrognathic position of mandible, and narrow maxilla at the level of first premolars were related to their mothers' corresponding features. The presence of lateral palatine ridges, which were detected in one third of the TS subjects, was related to the narrowness of the posterior palate rather than to the variation in the tongue position. Distinct craniofacial features segregate in cleft family members. The several significant associations in distinct craniofacial dimensions between parents and children with CLP emphasize the importance of genetic factors in the genesis of nonsyndromic orofacial clefting. The present results support the concept that maternal factors contribute to the degree of deficiency in the growth of the cranial base and to the magnitude of mandibular retrognathism of their daughters with TS. Maternal influences may also modify the width of the palate in TS.

Indiana University-Purdue University Indianapolis (IUPUI) / Obturator therapy has been proposed for many years as an aid in maxillary orthopedics for the complete unilateral cleft lip and palate infant. The obturator appliance had the added benefit of providing a false palate against which the infant can suckle. This has aided in the feeding of these infants to assure adequate nutrition with the least effort for parent and child. The current study assessed three aspects of obturator therapy at James Whitcomb Riley Hospital for Children, Indianapolis, Indiana. Parental evaluations of the obturator proved to be very positive. Almost all parents (96%) rated it as beneficial and would recommend its use to other parents with cleft lip and palate infants. Weight gain analysis over the first nine months of life demonstrated that these infants were only slightly below the average for birth weight. At three and nine months of age, a number (69% and 56% respectively) had maintained their original weight percentile rankings or had just dropped into the next lower category. Thus, many of the infants were able to achieve adequate nutrition, a problem noted by many authors when obturator therapy was not used. It should be emphasized that each infant underwent either one or two major surgical procedures during this time period. Arch symmetry assessments at one, four and ten months showed a gradual reduction in lateral posterior crossbite, canine crossbite, and anterior crossbite tendency. Although the arches still showed some collapse at the end of ten months of age, the pattern was much better than at initial presentation with values much closer to normal. Improvements in arch symmetry was expected as the maxilla grew. From the results of this study, obturator therapy appears to be beneficial in maxillary orthopedics by helping to maintain adequate weight gain and gain parental acceptance.

No description available.

Indiana University-Purdue University Indianapolis (IUPUI) / This investigation examined the relationship of the self-concept of children with cleft lip and palate to the self-concept of non-cleft children. Fifty cleft lip and palate children between the ages of eight and 18 were individually matched by age, sex and race with 50 non-cleft children. Each child was given the Piers-Harris Children's Self-Concept Scale. Children with clefts, regardless of sex, reported significantly lower global self-concept than non-cleft subjects (p < .005). Further significant differences between cleft and non-cleft subjects were found in five of six cluster scores. These included: behavior (p < .05), school status (p < .05), popularity (p < .05), happiness and satisfaction (p < .001), and physical attributes and appearance (p < .001). A significant effect (p < .01), was found on the popularity score, with cleft males feeling less popular than their non-cleft peers. A significant effect was also found on the anxiety score, with cleft females reporting significantly more anxiety (p < .01) than their non-cleft peers. A questionnaire was completed by the parents of the cleft and non-cleft subjects evaluating their child's relationship with family, peers and progress in school. In general, parents of both groups reported positive ratings of their child's social interactions. Parents of cleft. . subjects reported more negative responses than the parents of non-cleft subjects concerning the teasing the child experiences because of his/her facial appearance (p < .05) and the effect that the child's facial appearance had on progress in school (p < .05).

Indiana University-Purdue University Indianapolis (IUPUI) / The question of growth attenuation of the maxillary complex arises in connection with primary osteoplasty procedure. The deficiencies associated with the development of the jaws in unilateral complete cleft lip and palate (UCLP) children is an ongoing problem in terms of growth inhibition and orthodontic treatment. Retardation of growth can be attributed to intrinsic cleft factors and/or associated with the treatment of the cleft condition. In this study, the extent of such deficiency, if any, was investigated by assessing arch length, arch width, arch symmetry and inter-arch harmony. Seventeen orthodontic casts of UCLP children (mean age 7 years 11 months) were obtained. All were treated with a primary osteoplasty at James Whitcomb Riley Hospital for Children at Indianapolis, Indiana. The sample was compared to an age and sex matched non-cleft control group (n=38). None of the subjects had undergone orthodontic treatment beyond infant maxillary orthopedics. Anatomic landmarks were identified and digitized by means of optical electronics. The data were automatically fed into a computer which executed preprogrammed data manipulation algorithms. Significant (p<0.05) inhibition of growth has taken place in the maxillary arches of the UCLP group in both anteroposterior and transverse directions. lntercanine width (ICW) was reduced on average by 7.6 mm (23.6 percent) while the intermolar width (IMW) was shortened by 3.9 mm (7.8 percent). Sagittal growth was retarded by 5.5 mm (17.4 percent). A gradient of "normalization" originating at a point of surgical insult was observed anteroposteriorly in the transverse maxillary dimension. In the mandible, ICW was retarded by 2.0 mm (7.8 percent) while IMW and A-P growth vectors were not significantly affected. This investigation also revealed significant (p = 0.0001) differences in the size of the maxillary anterior palatal area (cleft mean = 83.5 mm2, non-cleft mean = 133.9 mm2). These findings lead to the conclusion that primary osteoplasty may contribute to maxillary growth attenuation with concomitant mandibular compensatory growth patterns.