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A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Master of Science in Dentistry Johannesburg, 2015 / Background: The purpose of this study was to determine and evaluate the prevalence, distribution and characteristics of dehiscences and fenestrations in skulls of a South African population and to discover if there is a link between their presence and specific characteristics. Methods and materials: A sample of 333 skulls with both jaws and a partial or complete dentition whose sex, age and ethnicity was known, were obtained from the Raymond A. Dart Collection of Human skeletons in the School of Anatomical Sciences, University of the Witwatersrand, Johannesburg, dating from 1980 to 2014. The size and distribution of these defects was measured. Fenestrations were further classified according to their location. The position of the affected teeth in the arch and the size of these teeth in relation to the width of the jaw were also recorded. Results: A total of 770 alveolar defects were recorded. Of those, 579 were fenestrations 63.2% in the maxilla; 36.7% in the mandible and 191 dehiscences 72.8% in the mandible and 27.2% in the maxilla. The total number of defects in the maxilla (418) exceeded that of the mandible (352). In the maxilla, the teeth most commonly associated with both dehiscences and fenestrations were the first molars (39.2%) and canines (29.9%). In the mandible, the canines (34.9%) and the first premolars (28.8%) were the most commonly affected teeth. There was a higher proportion of fenestrations as opposed to dehiscences present in all teeth except the canines where dehiscences predominated. Conclusion: Gender, age and population had no influence on the defects observed in the samples. The number of teeth was the only factor significantly associated with the presence or absence of one or more alveolar defects.

In der Literatur wird die kieferorthopädische Bewegung auch als ätiologischer Faktor für die Entstehung gingivaler Rezessionen gesehen (Dorfman 1978; Toker und Ozdemir 2009). Bereits 1942 beschäftigte sich Oppenheim mit dem Einfluss der Kieferorthopädie auf das parodontale Gewebe und stellte bereits damals fest, dass selbst bei größter Sorgfalt negative Einflüsse auf das Parodont nicht vermieden werden können (Oppenheim 1942). Nach derzeitiger Datenlage scheint folgende Antwort gerechtfertigt zu sein. Im Zuge einer kieferorthopädischen Therapie kann es zu Rezessionen der marginalen Gingiva kommen und dies kann auch teilweise nicht verhindert werden. Die fachlich korrekt durchgeführte kieferorthopädische Therapie scheint per se kein erhöhtes Risiko für die Entstehung von Rezessionen zu sein. Dies setzt eine sorgfältige prätherapeutische Diagnostik, geeignete Kräfte und Verankerungselemente, Beibehaltung einer suffizienten Mundhygiene und die Beachtung anatomischer Limits voraus.

In der Literatur wird die kieferorthopädische Bewegung auch als ätiologischer Faktor für die Entstehung gingivaler Rezessionen gesehen (Dorfman 1978; Toker und Ozdemir 2009). Bereits 1942 beschäftigte sich Oppenheim mit dem Einfluss der Kieferorthopädie auf das parodontale Gewebe und stellte bereits damals fest, dass selbst bei größter Sorgfalt negative Einflüsse auf das Parodont nicht vermieden werden können (Oppenheim 1942). Nach derzeitiger Datenlage scheint folgende Antwort gerechtfertigt zu sein. Im Zuge einer kieferorthopädischen Therapie kann es zu Rezessionen der marginalen Gingiva kommen und dies kann auch teilweise nicht verhindert werden. Die fachlich korrekt durchgeführte kieferorthopädische Therapie scheint per se kein erhöhtes Risiko für die Entstehung von Rezessionen zu sein. Dies setzt eine sorgfältige prätherapeutische Diagnostik, geeignete Kräfte und Verankerungselemente, Beibehaltung einer suffizienten Mundhygiene und die Beachtung anatomischer Limits voraus.:Einleitung 3 Material und Methodik 5 Ergebnis 6 Häufigkeit und Verteilung von Rezessionen 6 Attached Gingiva 8 Biomechanik der kieferorthopädischen Zahnbewegung 11 Plaque, Gingivitis 15 Kraft 20 Intrusion 21 Extrusion 23 Expansion/Dehnung 23 Labial und Lingualbewegung/Labialstand 29 Proklination/Inklination 34 Knochendehiszenz/Knochenbedeckung 43 Systematische Literaturübersicht 59 Vorbeugende Maßnahmen 61 Diskussion 63 Zusammenfassung 68 Literaturverzeichnis 69

In the fight to reduce carbon emissions, it is easy to see the necessity of reducing energy consumption. Buildings consume a large amount of energy, and have significant potential for energy savings. One tool for realising these potential savings is building simulation. To be able to use building simulation, accurate models for windows are needed. The models include individual layer models, to determine the solar and longwave radiative behaviours, as well as whole-system models to determine heat flows through the various layers of fenestration systems. This thesis looks at both kinds of models for incorporating windows into building simulations. A new network whole-system model is implemented, and integrated into the California Simulation Engine building simulation software. This model is also used as the calculation engine for a stand-alone rating tool. Additionally, a measurement technique used to measure off-normal solar properties of drapery materials, as part of developing shading layer models, is investigated using a Monte Carlo simulation. The network model uses a very general resistance network, allowing heat transfer between any two layers in a complex fenestration system (CFS), whether they are adjacent or not, between any layer and the indoor or outdoor side, or between the indoor and outdoor sides, although this last case is unlikely. Convective and radiative heat transfer are treated using the same format, resulting in increased stability. This general resistance network is used to calculate indices of merit for the CFS using numerical experiments. This approach requires fewer iterations to solve than previous solution methods, and is more flexible. The off-normal measurement technique which was investigated used a sample holder inserted into an integrating sphere. This is a non-standard way of using an integrating sphere, and early analyses did not provide conclusive information as to the effect of the sample holder. A Monte Carlo analysis confirmed the amount of beam attenuation as being 20% for the sample holder used in the experiments. Also con firmed was the effectiveness of dual-beam integrating spheres in correcting for the presence of a sample holder. The stand-alone rating tool which uses the general network framework, incorporates an easy-to-use visual interface. This tool models multiple types of shading layers with no restrictions on how they are combined. Users can easily change any one layer to see the effects of different arrangements. Users may specify any combination of indoor and outdoor ambient and mean radiant temperatures, insolation, and beam/diffuse split.

In the fight to reduce carbon emissions, it is easy to see the necessity of reducing energy consumption. Buildings consume a large amount of energy, and have significant potential for energy savings. One tool for realising these potential savings is building simulation. To be able to use building simulation, accurate models for windows are needed. The models include individual layer models, to determine the solar and longwave radiative behaviours, as well as whole-system models to determine heat flows through the various layers of fenestration systems. This thesis looks at both kinds of models for incorporating windows into building simulations. A new network whole-system model is implemented, and integrated into the California Simulation Engine building simulation software. This model is also used as the calculation engine for a stand-alone rating tool. Additionally, a measurement technique used to measure off-normal solar properties of drapery materials, as part of developing shading layer models, is investigated using a Monte Carlo simulation. The network model uses a very general resistance network, allowing heat transfer between any two layers in a complex fenestration system (CFS), whether they are adjacent or not, between any layer and the indoor or outdoor side, or between the indoor and outdoor sides, although this last case is unlikely. Convective and radiative heat transfer are treated using the same format, resulting in increased stability. This general resistance network is used to calculate indices of merit for the CFS using numerical experiments. This approach requires fewer iterations to solve than previous solution methods, and is more flexible. The off-normal measurement technique which was investigated used a sample holder inserted into an integrating sphere. This is a non-standard way of using an integrating sphere, and early analyses did not provide conclusive information as to the effect of the sample holder. A Monte Carlo analysis confirmed the amount of beam attenuation as being 20% for the sample holder used in the experiments. Also con firmed was the effectiveness of dual-beam integrating spheres in correcting for the presence of a sample holder. The stand-alone rating tool which uses the general network framework, incorporates an easy-to-use visual interface. This tool models multiple types of shading layers with no restrictions on how they are combined. Users can easily change any one layer to see the effects of different arrangements. Users may specify any combination of indoor and outdoor ambient and mean radiant temperatures, insolation, and beam/diffuse split.

Traumatismo em dentes decíduos pode causar sequelas tanto na dentição decídua como permanente. Em dentes decíduos, uma destas sequelas é a alveólise. Este estudo teve como objetivos: adequar a definição do termo alveólise e sugerir sua classificação em incisivos decíduos traumatizados; verificar sua ocorrência no Centro de Pesquisa e Atendimento de Traumatismo em Dentes Decíduos da Disciplina de Odontopediatria da FOUSP e fazer análise descritiva dos tipos de alveólise com as variáveis relacionadas a criança, ao trauma e ao dente. Um examinador avaliou 2516 prontuários (fichas, radiografias e fotografias) e selecionou 64 casos. Após critérios de inclusão e exclusão, foram analisados 61 prontuários apresentando 73 incisivos superiores decíduos com alveólise. A ocorrência de alveólise foi de 2,4%, sendo 43,8% das crianças entre 4,1 a 5 anos de idade e 63% do sexo masculino. O dente mais afetado foi o incisivo central superior decíduo (89%). Após a classificação de alveólise, verificou-se ocorrência de 9,6% dos dentes com fenestração apical, 19,2% com deiscência total e 71,2% com deiscência parcial. A média de tempo decorrido entre o trauma e o diagnóstico de alveólise foi de 15 meses para fenestração apical, 23,5 meses para deiscência total e 7,5 meses para deiscência parcial. A oclusão em 57,5% das crianças no diagnóstico era normal. O traumatismo periodontal ocorreu em 86,3% dos dentes, sendo que os traumatismos do tipo luxação e luxação lateral foram os mais encontrados em: 42,8% dos dentes com fenestração apical, 35,7% com deiscência total e 57,7% com deiscência parcial. O traumatismo de alta severidade ocorreu na maioria dos dentes com alveólise (82,2%). Clinicamente, 71,2% dos dentes apresentaram padrão angular e 8,2% padrão linear. Em 21,9% dos dentes observou-se perda óssea proximal. Em 89% dos dentes não ocorreu lesões de cárie e 87,7% não tiveram trauma de repetição. O tratamento endodôntico prévio não foi realizado em 94,5% dos dentes. A necrose pulpar foi observada em todos os casos de fenestração apical e em 92,9% dos casos de deiscência total. Em 76,9% dos casos de deiscência parcial não observouse necrose. Todos os dentes com fenestração apical e 85,7% dentes com deiscência total foram extraídos. Nos casos de deiscência parcial, quase metade dos dentes (44,2%) foram acompanhados. Neste estudo, a alveólise em incisivos decíduos foi definida como patologia ósseo-gengival, caracterizada pela exposição da porção apical e/ou vestibular da raiz do decíduo na cavidade bucal, devido a reabsorção da tábua óssea vestibular, com ou sem envolvimento do osso alveolar marginal, causada por infecção periapical e/ou periodontal originada por cárie, traumatismo dentário ou pela pressão do dente no osso alveolar no momento do trauma. Alveólise pode ser classificada: fenestração apical e deiscência total ou parcial. Clinicamente pode apresentar padrões tipo linear ou angular (mesial, vestibular, distal). Radiograficamente, a perda óssea proximal pode ser classificada em horizontal ou vertical. Alveólise é uma sequela de baixa ocorrência, e o tratamento de escolha para fenestração apical e deiscência total é a exodontia e para deiscência parcial pode ser o acompanhamento clínico e radiográfico ou exodontia, dependendo da gravidade do caso. / Dental trauma in primary teeth may cause sequelae in both primary and permanent dentition. One sequelae in primary teeth is alveolysis. This study aimed: to adjust the definition of alveolysis and to suggest its classification in traumatized primary incisors; to verify its occurrence at the Center of Research and Treatment of Dental Trauma in Primary Teeth of the School of Dentistry of the University of Sao Paulo and to do a descriptive analysis of the variables child, trauma and tooth related to the types of alveolysis. One examiner evaluated 2516 charts (records, radiographs and photographs) and found 64 eligible cases. After inclusion and exclusion criteria, 61 records were analyzed. Alveolysis was found in 73 upper primary incisors. Its occurrence was 2.4% and it was mostly present in male (63%) and children aged between 4.1 to 5 years (43.8%). The primary upper central incisor was the most affected tooth (89%). After classification of alveolysis, the evaluated teeth presented: apical fenestration (9.6%), total dehiscence (19.2%) and partial dehiscence (71.2%). The meantime between trauma and diagnosis of alveolysis was 15 months for apical fenestration, 23.5 months for total dehiscence and 7.5 months for partial dehiscence. The occlusion at diagnosis was normal in 57.5% of the cases. Periodontal trauma occurred in 86.3% of teeth; luxation and lateral luxation were found in 42.8% of teeth with apical fenestration, 35.7% of teeth with complete dehiscence and 57,7% of teeth with partial dehiscence. Trauma severity was high in mostly teeth (82.2%). Clinically, it was found that 71.2% of the teeth presented angular pattern and 8.2% of the teeth presented linear pattern. Proximal bone loss was observed in 21.9% of teeth. We observed that 89% of the teeth did not presented caries and 87.7% of the teeth did not repeated trauma. The previous endodontic treatment was performed in 94.5% of the teeth. Pulp necrosis was observed in all cases of apical fenestration and in 92.9% of the cases of total dehiscence; 76.9% of the cases of partial dehiscence, pulp necrosis was not observed. All teeth with apical fenestration and 85.7% of the teeth with total dehiscence were extracted. In cases related to partial dehiscence, almost half of the teeth (44.2%) were followed up. In this study, alveolysis in primary incisors was defined as a bone-gingival pathology characterized by the exposure of the apical and/or buccal root portion in the oral cavity. The root exposure is due to the bone resorption of the buccal bone plate with or without marginal alveolar bone involvement. This resorption is caused by periapical and/or periodontal infection caused by tooth decay, dental trauma or pressure of the alveolar bone at the time of dental trauma. Alveolysis can be classified into: apical fenestration and total/partial dehiscence. Clinically, patterns such as linear or angular (mesial, buccal, distal) may be observed. Radiographically, the proximal bone loss may be classified in horizontal or vertical. Alveolysis has low incidence and the chosen treatment for apical fenestration and total dehiscence is the tooth extraction, and for partial dehiscence, the treatment can be clinical/radiographic monitoring and extraction, which depends on the case severity.

Esta Tese de Doutorado é o resultado de uma pesquisa sobre a utilização das esquadrias de alumínio em edifícios de apartamentos, padrão médio-alto, na Cidade de São Paulo. Trata da análise dos critérios de escolha das esquadrias de alumínio para uso nas edificações categorizadas acima, considerando todas as etapas pertinentes ao processo de adoção destes componentes, incluindo: seleção dos materiais; especificação técnica; comercialização; fabricação e instalação. Paralelamente, o desenvolvimento deste trabalho permitiu analisar o inter-relacionamento entre os profissionais envolvidos na cadeia produtiva das esquadrias de alumínio, particularmente fornecedores e clientes, representados respectivamente por fabricantes de esquadrias de alumínio e construtoras. A expectativa é que o produto resultante desta Tese forneça subsídios para futuros estudos sobre os temas tratados e; principalmente, contribua para o aprimoramento de toda cadeia produtiva das esquadrias de alumínio para os edifícios residenciais de apartamentos. / This Thesis is the result of a research on aluminum fenestration, used in residential apartment buildings of medium-high standard in São Paulo City. It is about the choice criterions analysis of aluminum fenestration for use in this kind of residential apartment buildings, considering all the relevant adoption process stages of these components, including: materials selection; technical specification; commercialization; fabrication and installation. In parallel, the development of this job could permit to analyses the inter-relationship between the professionals involved in the aluminum fenestration supply chain, particularly suppliers and customers, respectively represented by aluminum fenestration systems manufactures and building contractors. The expectation is that the resulting product of this Thesis could supply subsidies for future studies of the subject and, principally, could contribute for the improvement of all aluminum fenestration supply chain for residential apartment buildings.

Esta Tese de Doutorado é o resultado de uma pesquisa sobre a utilização das esquadrias de alumínio em edifícios de apartamentos, padrão médio-alto, na Cidade de São Paulo. Trata da análise dos critérios de escolha das esquadrias de alumínio para uso nas edificações categorizadas acima, considerando todas as etapas pertinentes ao processo de adoção destes componentes, incluindo: seleção dos materiais; especificação técnica; comercialização; fabricação e instalação. Paralelamente, o desenvolvimento deste trabalho permitiu analisar o inter-relacionamento entre os profissionais envolvidos na cadeia produtiva das esquadrias de alumínio, particularmente fornecedores e clientes, representados respectivamente por fabricantes de esquadrias de alumínio e construtoras. A expectativa é que o produto resultante desta Tese forneça subsídios para futuros estudos sobre os temas tratados e; principalmente, contribua para o aprimoramento de toda cadeia produtiva das esquadrias de alumínio para os edifícios residenciais de apartamentos. / This Thesis is the result of a research on aluminum fenestration, used in residential apartment buildings of medium-high standard in São Paulo City. It is about the choice criterions analysis of aluminum fenestration for use in this kind of residential apartment buildings, considering all the relevant adoption process stages of these components, including: materials selection; technical specification; commercialization; fabrication and installation. In parallel, the development of this job could permit to analyses the inter-relationship between the professionals involved in the aluminum fenestration supply chain, particularly suppliers and customers, respectively represented by aluminum fenestration systems manufactures and building contractors. The expectation is that the resulting product of this Thesis could supply subsidies for future studies of the subject and, principally, could contribute for the improvement of all aluminum fenestration supply chain for residential apartment buildings.

Shading devices have the potential to reduce peak cooling load and annual energy consumption because they can be used to control solar gain. Thus, the need to model shading devices in a glazing system analysis is important. This thesis deals with various measurement techniques and model development related to solar optics in windows with shading devices. It also considers longwave radiative properties of shading devices via model development and experimentation. The different shading devices examined were roller blinds, insect screens, pleated drapes and venetian blinds. The energy performance of windows with shading devices was modeled using a two step procedure. Solar radiation was considered in the first step by developing a multi-layer solar optical model for glazing/shading systems. This newly developed model is an extension of an existing model for systems of specular glazing layers and includes the effect of layers that create scattered, specifically diffuse, radiation in reflection and/or transmission. Spatially-averaged (effective) optical properties were used to characterise shading layers, including their beam-diffuse split. The multi-layer solar optical model estimates the system solar transmission and absorbed solar components. The absorbed solar components appear as energy source terms in the second step – the heat transfer analysis. The heat transfer analysis involves the formulation of energy balance equations and requires both effective longwave properties and convective heat transfer coefficients as input. The simultaneous solution of the energy balance equations yields the temperature as well as the convective and radiative fluxes. The effective solar optical properties of flat materials like drapery fabrics, roller blinds and insect screens were obtained by developing a new measurement technique. Special sample holders were designed and fabricated to facilitate measurements using an integrating sphere installed in a commercially available spectrophotometer. Semi-empirical models were then developed to quantify the variation of solar optical properties with respect to incidence angle. In turn, effective layer properties of venetian blinds and pleated drapes were modeled using a more fundamental net radiation scheme. The effective longwave properties of flat materials were obtained by taking measurements with an infrared reflectometer using two backing surfaces. The results enabled simple models to be developed relating emittance and longwave transmittance to openness, emittance and longwave transmittance of the structure. In turn, effective longwave properties of venetian blinds and pleated drapes were modeled using a net radiation scheme. Convective heat transfer correlations were readily available. Finally, the newly developed models were validated by measuring the solar gain through various shading devices attached to a double glazed window using the National Solar Test Facility (NSTF) solar simulator and solar calorimeter. Solar gain results were also obtained from simulation software that incorporated the models. There was good agreement between the measured and the simulated results thus strengthening confidence in the newly developed models.