Made available in DSpace on 2014-06-11T19:28:03Z (GMT). No. of bitstreams: 0 Previous issue date: 2002-02-26Bitstream added on 2014-06-13T20:57:40Z : No. of bitstreams: 1 oliveira_ca_me_arafo.pdf: 227077 bytes, checksum: bd756a932166596c8abaefd6455879f6 (MD5) / O propósito deste estudo foi analisar histologicamente a utilização da matriz dérmica acelular (AlloDermâ) associada ou não à proteína derivada da matriz do esmalte (Emdogainâ) em recessões gengivais criadas cirurgicamente em cães. Foram criados defeitos periodontais na superfície vestibular dos caninos superiores de seis cães. Estes foram submetidos à indução do acúmulo de placa por oito semanas, e após este período foram divididos e tratados em dois grupos: grupo I: matriz dérmica acelular; grupo II: matriz dérmica acelular associada à proteína derivada da matriz do esmalte, ambos com reposição coronária do retalho. Após três meses os animais foram sacrificados, os dentes retirados em bloco e processados histologicamente. Realizou-se análise histológica descritiva e histométrica, medindo-se a extensão do tecido epitelial, neoformação óssea e cementária, nível gengival, inserção conjuntiva e tamanho do defeito para os grupos I e II. Os resultados demonstraram valores estatisticamente iguais para as médias dos valores de cemento: 0.06 mm e 0.32 mm; osso: -0,75 mm e -0,86 mm; nível gengival: -2,15 mm e -3,11 mm; tamanho do defeito: 4,90 mm e 5,51 mm, respectivamente para os grupos I e II. Foi encontrada diferença estatisticamente significante em relação tecido epitelial, com médias de 2,88 mm e 2,15 mm, respectivamente para os grupos I e II. Não foi encontrada inserção conjuntiva. Com isso, pudemos concluir que o Emdogainâ não trouxe efeitos adicionais quando associado ao AlloDermâ. / The purpose of the present study was to histologically evaluate the healing of acellular dermal matrix (AlloDermâ), associated or not, a enamel matrix proteins (Emdogainâ) in gingival recessions defects created in dogs. Recessions defects were surgically created (5X7 mm) on the buccal aspect of the uppercuspids in contralateral jaw quadrants, in 6 mongrel dogs. The defects were exposed to plaque accumulation for 2 months. After they were divided into 2 groups, according to the treatment applied: Group I- acellular dermal matrix and coronally positioned flap; Group II: acellular dermal matrix, enamel matrix proteins and coronally positioned flap. After 3 months, the animals were sacrificed, and the blocks obtained were processed. Histologic and histometric analysis were performed to examine: ephithelium formation, cementum and bone regeneration, connective tissue adaptation, attachment level and defect measure. Results did not show a statistically significant difference in the cementum and bone regeneration, connective tissue adaptation, attachment level and defect measure parameters. The mean values were: 0,06 mm and 0,32 mm for cementum regeneration; -0,75 mm and -0,86 mm for bone regeneration; -2,15mm and -3,11 mm for attachment level; and 4,90 mm and 5,51 mm for defect measure, in the I and II groups, respectively. The ephithelium formation parameter was 2,88 mm and 2,15 mm, in the I and II groups, respectively, with a statistically significant difference. Within limits of this study, it can be concluded that Emdogainâ not brought additional effects when associated with AlloDermâ.

Trabajo de Investigación Requisito para optar al Título de Cirujano Dentista / Autor no autoriza el acceso a texto complete de su tesis en el programa de tesis Electrónicas / Introducción: La periodontitis apical asintomática (PAa) es una patología inmunoinflamatoria de origen infeccioso que se caracteriza por destrucción del tejido óseo periapical y está asociada a expresión de diversos mediadores inflamatorios. El factor de crecimiento vascular endotelial (VEGF) participa en angiogénesis, aumento de la permeabilidad vascular y vasodilatación, fenómenos centrales en la patogenia de la PAa. La interleuquina 1-β (lL-1β) en procesos inflamatorios promueve la reabsorción ósea, la síntesis de prostaglandinas y la producción de proteasas. A la fecha se desconoce la presencia y niveles de VEGF e lL-1β en fluido gingival crevicular (FGC) de dientes con PAa. Objetivo: Comparar los niveles de IL-1β y VEGF en el fluido gingival crevicular (FGC) de dientes con periodontitis apical asintomática (PAa) en forma previa, tras la realización del tratamiento endodóntico y en dientes controles contralaterales sanos. Materiales y método: Se obtuvieron muestras de FGC de dientes con PAa al momento del diagnóstico inicial (n=23) y 7 días post tratamiento endodóntico y de dientes contralaterales sanos (n=23). Las muestras de FGC fueron eluídas y se midió la concentración de proteínas totales (CPT). Los niveles de VEGF y de IL1-β se determinaron mediante FlowCytomix. Para el análisis estadístico se aplicó el programa Stata v.11.1 Resultados: Se observó similitud en la CPT de los grupos de PAa pre y post tratamiento endodóntico y niveles mayores en grupo control versus grupo PAa pre tratamiento. En relación a niveles de IL 1-β se observó similitud de niveles entre los grupos pre tratamiento y controles, mientras que los niveles son mayores en el grupo post tratamiento. Se detectó presencia de VEGF pero no niveles, por dificultades en la medición, encontrándose mayor frecuencia de detección en el grupo PAa post tratamiento versus controles y PAa pre tratamiento. Conclusiones: No se observaron diferencias significativas en los niveles de CPT e IL-1β en FGC de dientes sanos y enfermos pre y post tratamiento endodóntico. Por el contrario, sí se observaron diferencias estadísticamente significativas en los niveles de VEGF al comparar PAa post tratamiento versus controles, no encontrándose correlación en niveles de VEGF entre PAa y controles. No se encontró correlación de los mediadores estudiados en FGC, con los estados de salud/enfermedad en la muestra analizada.

Trabajo de Investigación Requisito para optar al Título de Cirujano Dentista / INTRODUCCIÓN: La recesión gingival (RG) es una condición común e indeseable que puede alterar la encía. Afecta principalmente a la población adulta con enfermedad periodontal o secuela de su tratamiento, así como también a personas sanas.A pesar que globalmente los estudios sobre recesión gingival son numerosos en adultos, en Chile existe un limitado número de estudios e epidemiológicos de recesión gingival. El objetivo de la presente investigación fue reportar la prevalencia, distribución, extensión y severidad de las recesiones gingivales vestibulares en adultos chilenos entre 35–44 años. MATERIALES Y MÉTODOS: Se desarrolló un estudio descriptivo, analizando la base de datos del Proyecto “Prevalencia de enfermedades bucales e indicadores de riesgo en la población 35-44 y 65-74 años de Chile”. Se seleccionaron 703 periodontogramas de participantes entre 35–44 años con al menos 20 dientes. La prevalencia fue definida como el porcentaje de participantes que tuvieran al menos un sitio con posición de la encía apical al límite amelo-cementario. La extensión, como el porcentaje de sitios comprometidos, en localizada (RGL)(<30%) y generalizada(RGG) (≥30%). La distribución se evalúo según la ubicación por arcada, diente y sitio. Y la severidad en leve (1-2mm), moderada (2-3mm) y severa (≥5mm) de acuerdo a la longitud corono-apical de superficie radicular no cubierta por encía. RESULTADOS: La prevalencia de la RG vestibular fue de 93.5%, encontrándose un promedio de 12.4+8.2 dientes afectados. El porcentaje de individuos que presentó RGL correspondió al 43.8% y el 56.2% presentó RGG. Las RG vestibulares leves representaron el 46.27%, las moderadas el 45.05% y las severa el 8.69%. Los primeros molares maxilares fueron los más afectados, específicamente, los sitios mediales. A excepción de la severidad donde los hombres presentaron RG más severas, no existieron diferencias estadísticamente significativas entre los géneros. CONCLUSIONES: La recesión gingival en la población adulta chilena entre 35–44 años es prevalente, existiendo diferencia según género en su severidad.

No description available.

No description available.

Retalho posicionado coronalmente associado ao enxerto de tecido conjuntivo subepitelial (ETCS) é o padrão ouro para o tratamento de retrações gengivais. A matriz de colágena suína bioabsorvível Mucoderm® (MD) tem sido amplamente utilizada como substituto do ETCS e tem alcançado resultados semelhantes. o MD tem a vantagem de disponibilidade que supera as limitações do sítio doador em enxertos autógenos. O objetivo deste estudo é investigar o uso do MD nos procedimentos de recobrimento radicular combinado com retalho extendido posicionado coronalmente (REPC), grupo teste (GT), em comparação ao ETCS associado ao REPC, grupo controle (GC). Dezoito pacientes adultos, apresentando recessão tipo 1 bilateral foram selecionados. Parâmetros clínicos, profundidade de sondagem, nível clínico de inserção, altura (RG) e largura (LRG) da retração, altura (GQ) e espessura (EGQ) da gengiva queratinizada e área da retração (ARG) foram registrados no início, 3 e 6 meses após os procedimentos cirúrgicos por um examinador cego. Aos 6 meses, um periodontista realizou uma Escala Estética de Recobrimento Radicular (ERR) (Cairo et al. 2009) analisando a posição da margem gengival (MG), contorno do tecido marginal (CTM), textura do tecido mole (TTM), alinhamento da junção mucogengival (AJG) e coloração da gengiva (CG). Aos 3 e 6 meses, um questionário estético funcional para o paciente foi utilizado para avaliar a satisfação com a taxa de recobrimento (STR), coloração da gengiva (CG) e sensibilidade dentinária (SEN), esta última aplicada também no baseline, e se necessário, voltaria a realizar a cirurgia (CIR) em outras áreas. O paciente respondeu ao questionário em uma escala VAS. O GT e o GC apresentaram redução significativa na média da RG (3,33 ± 0,89mm a 1,31 ± 1,03mm (p &lt0,05) e 3,21 ± 0,80mm a 0,83 ± 0,86mm ( p &lt0,05)), LRG (4,03 ± 0,57mm a 2,73 ± 1,62mm 12 e 4,10 ± 0,63mm a 2,07 ± 1,79mm (p &lt0,05)) e ARG (222638 ± 99731pix&sup2 para 72727 ± 82631pix&sup2 e 196461 ± 84815pix&sup2 para 48414 ± 63398pix&sup2 (p &lt0,05)) respectivamente e ganho de GQ (1,87 ± 1,17mm para 2,85 ± 1,43mm (p &lt0,05) e 1,91 ± 0 , 95mm a 2,83 ± 1,41mm (p &lt0,05)) e EGQ (0,76 ± 0,21mm a 1,10 ± 0,31mm (p &lt0,05) e 0,86 ± 0,39mm a 1, 36 ± 0,40mm (p &lt0,05)) respectivamente em um período de 6 meses. A quantidade média de cobertura radicular não foi diferente entre GT (61,33%) e GC (73,90%) (p&gt 0,05). Não houve diferença entre o GC e o GT nos parâmetros analisados no ERR aos 6 meses e para o questionário estético funcional ao paciente houve redução significativa no parâmetro SEN no GT (54,55 ± 32,60% para 19,11 ± 25,73% (p &lt0,05)) e GC (55,61 ± 30,88% a 11,17 ± 17,51% (p &lt0,05)). Ambos os grupos mostraram uma redução significativa na RG. Considerando-se que não foram observadas diferenças significativas entre o GC e o GT para RG, LRG, ARG e GQ e EGQ foram significativamente diferentes favorecendo GT, pode-se especular que o MD possa ser usado como alternativa ao CTG para o tratamento de recessões gengivais / Coronally advanced flap plus connective tissue graft (CTG) is the gold standard therapy for root coverage. The bioabsorbable porcine collagen matrix Mucoderm® (MD) has been widely used in periodontal and mucogingival surgery as a substitute for CTG and has achieved similar results. The MD has the advantage of availability overcoming the limitations of donor site in autograft. The aim of this study is to investigate the use of MD in root coverage procedures combined with extended coronally positioned flap (ECAF), test group (TG) in comparison to the CTG associated with the ECAF, control group (CG). Eighteen adult patients, non-smokers, presenting bilateral Cairo´s Recession Type 1 (RT1) were selected. Clinical parameters, probing depth, clinical attachment level, recession height (RH) and width (RW), keratinized tissue height (KTH) and thickness (KTT) and gingival recession área (GRA) were recorded at baseline,3 and 6 months after the surgical procedures by a blinded examiner. At 6 months a specialist in periodontics performed a Root Coverage Esthetic Score (RES) (Cairo et al. 2009) analyzing position of the gingival margin (GM), marginal tissue contour (MTC), soft tissue texture (STT), mucogingival junction alignment (MJA) and gingival color (GI). At 3 and 6 months a functional aesthetic questionnaire to the patient was used to evaluate the satisfaction with recovering rate (SRR), gingival color (GI) and dentin sensitivity (SEN) (the latter applied initially in the baseline) and, if necessary, would return to perform the surgery (SUR) in other areas. The patient answered the questionnaire on a VAS scale.The TG and CG showed a significant reduction in average for RH (3.33 ± 0.89mm to 1.31±1.03mm (p&lt0.05) and 3.21±0.80mm to 0.83±0.86mm (p&lt0.05)), RW (4.03±0.57mm to 2.73±1.62mm and4.10±0.63mm to 2.07±1.79mm (p&lt0.05)) and GRA (222638±99731pix&sup2 to 72727±82631pix&sup2 and 196461±84815pix&sup2 to 48414±63398pix&sup2 (p&lt0.05)) respectively and gain of KTH (1.87±1.17mm to 2.85±1.43mm (p&lt0.05) and 1.91±0.95mm to 2.83±1.41mm (p&lt0.05)) and KTT 14 (0.76±0.21mm to 1.10±0.31mm (p&lt0.05) and 0.86±0.39mm to 1.36±0.40mm (p&lt0.05)) respectively in a period of 6 month. The average amount of root coverage was not different between TG (61.33%) and CG (73.90%) (p&gt0.05). There was no differences between CG and TG on the parameters analyzed in the RES on 6 months and for the functional aesthetic questionnaire to the patient significant reduction was found on SEN parameter on TG (54.55±32,60% to 19.11±25.73% (p&lt0.05)) and CG (55.61±30.88% to 11.17±17.51% (p&lt 0.05)).In these 6 months follow up study, both groups showed a significant reduction in recession height. Considering no significant differences were observed between CG and TG for RH, RW, GRA and KTH and KTT were significant different favoring TG, it can be speculated that MD can be used as an alternative to CTG for the treatment of gingival recessions

Thesis (doctoral)--Karolinska Institutet, Stockholm, 1986. / Extra t.p. with thesis statement inserted. Includes bibliographical references.

Les capacités de cicatrisation de la gencive en font un modèle de régénération tissulaire naturelle. Ces capacités sont liées en grande partie à l’activité des fibroblastes. Composante cellulaire principale du tissu conjonctif gingival, ils sont au cœur de la régulation des réponses inflammatoires et des processus de cicatrisation. Nous avons supposé que ce tissu pouvait contenir des cellules souches, pouvant expliquer en partie, ces capacités de réparation. Au cours de cette thèse, nous avons pu mettre en évidence la présence de cellules souches mésenchymateuses aux propriétés communes avec les cellules souches adultes dérivées des crêtes neurales. Ces cellules expriment des marqueurs spécifiques des cellules souches et des crêtes neurales. Par ailleurs, elles présentent des capacités d’auto-renouvellement et de multipotence. Elles sont, en effet, capables de se différencier en adipocytes, ostéocytes et chondrocytes. Nous nous sommes plus particulièrement intéressés à la différenciation chondro/endochondrale. La culture des cellules, sous forme de sphères en suspension, a permis de mettre en évidence leurs capacités de différenciation en tissus cartilagineux et articulaires. Elles s’organisent spontanément en plusieurs types cellulaires différents, générant notamment des chondrocytes hypertrophiques et des synoviocytes selon leur localisation au sein des sphères et du milieu de culture utilisé. Le comportement de ces cellules soumises à ces conditions a permis de montrer leurs facultés à reproduire, in vitro, des processus proches de ceux retrouvés au cours du développement. Ces résultats permettent une meilleure compréhension des phénomènes de différenciation des cellules souches adultes, ouvrant ainsi de nouvelles perspectives pour des applications en thérapie cellulaire articulaire et osseuse. / The healing capacity of the gingiva makes it a model of natural tissue regeneration. These capabilities are largely related to the fibroblast activity. They are the main cellular component of the gingival connective tissue and they regulate inflammatory responses and healing process. We hypothesized that this tissue could contain stem cells, which could explain, in part, these repair capabilities. In this thesis, we were able to demonstrate the presence of mesenchymal stem cells with properties shared with the neural crest-derived adult stem cells. These cells express specific markers of stem cells and neural crest. Moreover, they do have the capacity to self-renew and multipotency. They are, indeed, able to differentiate into adipocytes, chondrocytes and osteocytes. We have particularly focused on the chondro / endochondral differentiation. When cultivated as micromasses cultures in suspension, cells were able to differentiate into cartilage and joint tissues. They organize themselves spontaneously into several different cell types, including hypertrophic chondrocytes and synoviocytes depending on their location within the micromasses and the culture medium used. The behavior of these cells under these conditions has shown their ability to replicate in vitro, close to those found during the development process. These results allow a better understanding of adult stem cells differentiation, opening new perspectives for applications in joint and bone cell therapy.

No description available.

AIM: The aim of this investigation is to determine the prevalence of maxillary altered passive eruption in a dental school population. METHODS: 100 subjects were examined clinically and had models fabricated of their maxilla. Demographic, periodontal, cast measurements were recorded for each subject. Demographic variables recorded included age, gender, and ethnicity, history of orthodontic treatment, presence of incisal /occlusal wear, appearance of gingival excess, and presence of gingival asymmetry. Measurements made on cast included clinical crown length, clinical crown width, papillary height, and distance from the lateral gingival zenith to the gingival aesthetic line. Clinical crown width-to-length ratio was calculated. These measurements were compared to previously published standards. RESULTS: 83% of the subjects had central incisors with a clinical W:L ratio greater than .80. Logistical regression analysis determined that subjects with central incisors with an appearance of gingival excess were more likely to have a clinical W:L ratio greater than .80 (P<.0007; OR=79). ANOVA demonstrated that clinical crown length had a statistically significant relationship with gender (P<.0001), tooth type (P<.0001) and biotype (P<0.0026). Clinical crown width and clinical crown W:L ratio had a statistically significant relationship with gender (P<0.0007, P<.0001) and tooth type (P<0.0026, P<.0001). The average clinical crown length was 0.5-1.5 mm shorter than established ideal measurements. CONCLUSION: 83% of the subject population had central incisors that displayed altered passive eruption. Subjects who exceeded the clinical W:L ratio of .80 were more likely to have been classified as having the appearance of gingival excess or “gummy smile”. Esthetic crown lengthening should be considered to achieve desired esthetics in these subjects.