Made available in DSpace on 2014-10-09T12:26:39Z (GMT). No. of bitstreams: 0 / Made available in DSpace on 2014-10-09T14:06:22Z (GMT). No. of bitstreams: 0 / Dissertacao (Mestrado Profissionalizante em Lasers em Odontologia) / IPEN/D-MPLO / Instituto de Pesquisas Energeticas e Nucleares - IPEN-CNEN/SP; Faculdade de Odontologia, Universidade de Sao Paulo, Sao Paulo

Made available in DSpace on 2014-10-09T12:32:58Z (GMT). No. of bitstreams: 0 / Made available in DSpace on 2014-10-09T14:06:11Z (GMT). No. of bitstreams: 0 / A estomatite protética (EP), também designada de candidíase atrófica crônica, é a infecção fúngica bucal mais comum em indivíduos portadores de prótese total. Possui etiologia multifatorial, no entanto a presença de Candida spp. no biofilme da prótese é tida como o fator mais importante para o estabelecimento da EP. Este trabalho teve como objetivo avaliar o tratamento da EP por meio do uso da terapia fotodinâmica antimicrobiana (PDT), mediada pelo azul de metileno. Foram realizados estudos pré-clínicos e clínicos. Protótipos simuladores de prótese total foram confeccionados com polímero de metilmetacrilato, para servir de base para o crescimento do biofilme das seguintes espécies do gênero Candida: C. albicans, C. glabrata, C. dubliniensis, C. krusei, C. tropicalis, C. parapsilosis e C. guilliermondii. Como fotossensibilizador foi utilizada a solução de azul de metileno em uma concentração de 450μg/mL. Os protótipos com os biofilmes foram irradiados com um laser de comprimento de onda de 660 nm, potência de 100 mW, por um tempo de 80 segundos. Para o estudo clínico, os indivíduos foram divididos em dois grupos. O primeiro grupo recebeu tratamento convencional, à base do antifúngico Miconazol. O segundo grupo recebeu como tratamento a PDT. Os resultados pré-clínicos mostraram que todas as espécies do gênero Candida foram susceptíveis à PDT, ocorrendo uma redução de colônias que variou de 2,48 a 3,93 log10. Os resultados clínicos foram avaliados tanto quanto à redução de colônias de Candida spp. na mucosa e na prótese, como quanto à melhora do aspecto clínico da mucosa afetada. Tanto a terapia convencional quanto a PDT foram eficientes em tratar a EP. Não houve diferença estatística significante entre os tratamentos instituídos para nenhum dos fatores avaliados. Assim, concluiu-se que a PDT é efetiva no tratamento da estomatite protética. / Tese (Doutoramento) / IPEN/T / Instituto de Pesquisas Energeticas e Nucleares - IPEN-CNEN/SP

Made available in DSpace on 2014-10-09T12:45:40Z (GMT). No. of bitstreams: 0 / Made available in DSpace on 2014-10-09T14:08:26Z (GMT). No. of bitstreams: 1 07608.pdf: 2806838 bytes, checksum: c87c4e84bff5fffef152012c504c6fe7 (MD5) / Dissertacao (Mestrado Profissionalizante em Lasers em Odontologia / IPEN/D-MPLO / Instituto de Pesquisas Energeticas e Nucleares, IPEN/CNEN-SP; Faculdade de Odontologia, Universidade de Sao Paulo

Made available in DSpace on 2014-10-09T12:47:30Z (GMT). No. of bitstreams: 0 / Made available in DSpace on 2014-10-09T14:08:50Z (GMT). No. of bitstreams: 1 08993.pdf: 3665043 bytes, checksum: 35940cfadee781199852875c519f6f11 (MD5) / Dissertacao (Mestrado Profissionalizante em Lasers em Odontologia) / IPEN/D-MPLO / Instituto de Pesquisas Energeticas e Nucleares, IPEN/CNEN-SP; Faculdade de Odontologia, Universidade de Sao Paulo

Submitted by Marco Antonio Oliveira da Silva (maosilva@ipen.br) on 2017-11-09T12:05:14Z No. of bitstreams: 0 / Made available in DSpace on 2017-11-09T12:05:14Z (GMT). No. of bitstreams: 0 / A radioterapia clínica é de fundamental importância para o tratamento de lesões malignas localizadas na região de cabeça e pescoço, contudo, a exposição à irradiação ionizante, pode levar a complicações sistêmicas ou locais durante e após o tratamento radioterápico. Dentre estas complicações locais imediatas, destaca-se na cavidade oral a xerostomia e a consequente mucosite oral. A respeito das complicações tardias produzidas pela radioterapia, salientam-se a cárie de radiação e a osteorradionecrose, lesões dose dependentes, com alto nível de incidência nas últimas décadas e de difícil manejo, embora estas se apresentem após o término do tratamento e sob influência de fatores locais. A metodologia proposta no presente estudo visa analisar o efeito que exerce a radiação gama após a aplicação da radioterapia, utilizando-se a dose empregada em pacientes acometidos com câncer de cabeça e pescoço. As amostras foram obtidas a partir de esmalte dentário e dentina radicular humanos e osso mandibular suíno, as quais foram previamente polidas, e em seguida analisadas quanto à microdureza de superfície inicial de todos os grupos. Posteriormente, as amostras foram irradiadas sob uma taxa de dose de 4 Gy por dia, completando uma dose total de 72 Gy. Finalmente, as amostras foram submetidas a análise da microdureza de superfície após irradiação, a qual apresentou resultados estatisticamente significantes a partir dos testes de t de student, ANOVA e Tukey com respeito à diferença da média dos valores iniciais e finais de cada grupo de estudo com um valor de p = 0,00 (<0.05). Quanto à análise morfológica na microscopia eletrônica de varredura (MEV), o efeito deletério da irradiação gama manifestou-se na forma de trincas, quebras e fraturas superficiais dos tecidos analisados e à análise bioquímica pela técnica de reflexão total atenuada por meio da espectroscopia no infravermelho por transformada de Fourier (ATR - FTIR), a degradação dos componentes inorgânicos e a desnaturação dos compostos orgânicos foi evidente, pelo qual determinou-se o efeito deletério da irradiação gama sobre os tecidos duros da cavidade bucal com respeito às propriedades mecânicas, composicionais e morfológicas, e da ação contribuinte desta independente dos fatores locais e sistêmicos no paciente irradiado. / Dissertação (Mestrado em Tecnologia Nuclear) / IPEN/D / Instituto de Pesquisas Energéticas e Nucleares - IPEN-CNEN/SP

Metástases para a região oral podem ocorrer nos tecidos moles ou nos ossos maxilares. Tumores metastáticos para a cavidade oral são raros, compreendendo aproximadamente 1% das neoplasias encontradas na região oral. Devido à sua raridade, o diagnóstico de uma lesão metastática na região oral é difícil; tanto para o clínico como para o patologista, ao reconhecer que uma lesão é metastática e na determinação do local de origem. Foram revisados 9 casos sendo 5 mulheres e 4 homens com idades entre 57 e 80 anos e realizada uma crítica revisão da literatura. No presente estudo não foi possível determinar a prevalência das metástases para os ossos maxilares ou para os tecidos moles da cavidade oral; Entretanto, nosso estudo mostra que o exame das estruturas orais é absolutamente fundamental no acompanhamento desses pacientes, pois a presença de possíveis massas metastáticas pode indicar uma neoplasia oculta ou mesmo a falha terapêutica. / Metastasis to the oral region may occur in the soft tissue or jaw bone. Metastatic tumors to the oral cavity are rare, comprising about 1% of neoplasms found in the oral region. Because of its rarity, the diagnosis of a metastatic lesion in the oral region is difficult; both for the clinician and for the pathologist to recognize that an injury is metastatic and determination of the place of origin. 9 cases with 5 women and 4 men aged between 57 and 80 years and performed a critical review of the literature were reviewed. In the present study could not determine the prevalence of metastasis to the jaw bones or the soft tissues of the oral cavity; However, our study shows that the examination of oral structures is absolutely essential to monitor these patients, because the presence of possible metastatic masses may indicate a hidden cancer or treatment failure.

Objetivou-se fazer um estudo retrospectivo avaliando quais as afecções da cavidade oral foram mais frequentes nos gatos domésticos atendidos no Laboratório de Odontologia Comparada da Faculdade de Medicina Veterinária e Zootecnia da Universidade de São Paulo, relatando estatisticamente a prevalência das afecções da cavidade oral de gatos, enfatizando se há correlação entre elas e com características como raça, sexo, faixa etária e estado reprodutivo. Os dados analisados dos 754 prontuários foram raça, idade, sexo, estado reprodutivo, diagnóstico, tratamento e, no caso de neoplasia, sua localização e diagnóstico histopatológico. As principais doenças diagnosticadas foram doença periodontal, fratura dentária, gengivoestomatite crônica felina, lesão de reabsorção dentária felina, neoplasia oral e traumatismo do sistema estomatognático (luxação de articulação temporomandibular, fenda palatina, fratura de processo coronoide, fratura de zigomático, disjunção de sínfise, fratura de maxila e mandíbula). A idade dos animais variou de menos de um ano a 20 anos, sendo que, os animais tinham, em média 7,2 anos (desvio padrão &#61; 4,9) e a faixa etária mais frequente foi de um a cinco anos. Os gatos sem raça definida (66,5%), siameses (19,0%) e persas (10,2%) totalizaram 95,7% de todos os felinos atendidos no LOC. A doença periodontal foi a afecção mais frequente e esteve presente em 38,3% da população estudada. A fratura dentária, segunda mais frequente, esteve presente em 27,2% dos animais. Houve associação estatisticamente significativa (p&#61;0,026) entre fratura dentária e faixa etária, já que a proporção de animais entre um e cinco anos de idade com fratura foi maior do que a das outras faixas etárias. A lesão de reabsorção dentária felina (LRDF) esteve presente em 19,6% dos gatos estudados, sendo a terceira afecção mais prevalente dentre as pesquisadas. Esta lesão foi mais frequente em gatos com idade entre 11 e 15 anos e houve associação estatisticamente significativa entre a LRDF e a doença periodontal e entre LRDF e gengivite. A prevalência de gengivoestomatite crônica felina foi de 15,7% entre os felinos pesquisados e a proporção de animais com idades entre seis e dez anos com esta doença foi maior do que em outras faixas etárias. As neoplasias estavam presentes em 9,8% dos gatos, sendo que em 46 dos 72 animais que apresentaram alguma neoplasia tinham mais de dez anos de idade. O carcinoma de células escamosas foi o neoplasma mais comum, correspondendo a 63,2% das neoformações que foram submetidas ao exame histopatológico. As fraturas ósseas do sistema estomatognático corresponderam a 19,3% dos atendimentos, sendo a sínfise mentoniana e o corpo da mandíbula os locais mais comuns de fraturas. Concluiu-se que: existe grande variedade de afecções que acometem a cavidade oral de gatos, sendo a doença periodontal, fratura dentária, lesão de reabsorção dentária, gengivite, gengivoestomatite crônica, neoplasias orais e fraturas dos ossos do sistema estomatognático as mais prevalentes delas; é de extrema importância que as anotações nas fichas de atendimento sejam feitas da maneira mais completa possível, para que informações não sejam perdidas / This study aimed to make a retrospective study assessing which diseases of the oral cavity were more common in domestic cats attended at Comparative Dental Laboratory of the School of Veterinary Medicine and Zootechny of the University of São Paulo, and to report statistically the prevalence of diseases in the oral cavity of cats, emphasizing the correlation between them and with characteristics such as breed, gender, age and reproductive status. The data analyzed from 754 records were breed, age, gender, reproductive status, diagnosis, treatment and in the case of neoplasia, its location and histological diagnosis. The main diagnosed diseases were periodontal disease, tooth fracture, feline chronic gingivostomatitis, tooth resorption lesions, oral cancer and trauma of the stomatognathic system (dislocation of temporomandibular joint, cleft palate, coronoid fracture, zygomatic fracture, symphyseal separation, maxilla and mandible fracture). The age of the animals ranged from less than one year to 20 years, and the animals had an average of 7.2 years (SD &#61; 4.9) and the most frequent age range was from one to five years. Three breeds totaled 95.7% of all cats attended at LOC, which were, Persian (10.2%), Siamese (19.0%) and SRD (66.5%). Periodontal disease was the most common condition and it was present in 38.3% of the studied population. Dental fracture was present in 27.2% of the animals. There was a statistically significant association (p &#61; 0.026) between dental fracture and age, since the proportion of animals between one and five years old with fracture was higher than that of other age groups. The tooth resorption lesions (LRD) were present in 19.6% of the studied cats, being the third most prevalent disease among the survey. This injury was more common in cats aged between 11 and 15 years and there was a statistically significant association between LRD and periodontal and between gum disease and LRD. The prevalence of feline chronic gingivostomatitis was 15.7% among those surveyed cats and the proportion of animals aged between six and ten years with this disease was higher than other age groups. Neoplasia was present in 9.8% of cats, and in 46 of 72 animals that showed some malformation had more than ten years old. The squamous cell carcinoma was the most common neoplasm, corresponding to 63.2% of neoformations that were submitted to histopathology. Bone fractures of the stomatognathic system accounted for 19.3% of cases, the mandibular symphysis and the body of the mandible were the most common sites of fractures. It was concluded that there is a wide range of diseases that affect the oral cavity of cats, and periodontal disease, tooth fracture, dental resorption lesions, gingivitis, gingivostomatitis, oral cancer and fractures of the bones of the stomatognathic system were the most prevalent of them; it is a matter of utmost importance that the notes in all pacient records are done as thoroughly as possible, so that information will not be lost

Les carcinomes épidermoïdes de la cavité orale (CECO) représentent environ 25% des cancers de la tête et du cou (HNSCC). Ils sont associés à un mauvais pronostic avec une survie à 10 ans n'excédant pas ~ 30%. Alors que le virus du papillome humain (HPV) est un facteur de risque reconnu dans les HNSCC, il n'est pas impliqué dans les CECO dont les principaux facteurs de risque sont liés à la consommation d'alcool et de tabac. Cependant, plusieurs auteurs notent une part croissante de CECO chez des patients non exposés à l’alcool et au tabac (facteurs de risque négatifs: RF-) et dont le statut HPV est négatif. Il est aujourd’hui reconnu que le microenvironnement immunitaire (TME) peut jouer un rôle majeur dans la progression et l'échappement tumoral. Dans notre travail, nous avons cherché à savoir si les CECO RF- sont épidémiologiquement différents des CECO RF+ (facteurs de risques positifs: RF+) et si la composition immunitaire du TME et des cellules circulantes diffère selon ces deux groupes. Ainsi, dans une première partie, nous avons étudié une cohorte rétrospective de 553 patients atteints de CECO et comparé les paramètres cliniques et épidémiologiques entre les patients RF+ et RF-. Ensuite, nous avons étudié de manière prospective par rapport aux facteurs de risque ces deux entités d'un point de vue immunitaire en analysant des échantillons de sang et de tissus de 87 patients et en les comparant à des échantillons de tissus et de sang de témoins sains. Notre travail a permis d'associer une hétérogénéité clinique à des profils immunologiques distincts pouvant prédire un pronostic différent pour les patients RF+ ou RF- : puisque les CECO sont des cancers inflammatoires présentant un important infiltrat de divers composants immunitaires innés, il s'est avéré que la numération sanguine des lymphocytes T CD8+ supérieure à 306 cellules/μL chez les RF- et des cellules T régulatrices (Treg) supérieure à 47 cellules/μL chez les patients RF+ ont respectivement été associées à une meilleure survie sans maladie (DFS). En revanche, un pourcentage plus élevé de cellules Th17 dans le sang ou le TME de patients RF+ a été associé à une moins bonne survie sans récidive (DFS). Dans une troisième partie de cette thèse, nous avons étudié la migration d'un sous-ensemble de Treg exprimant CCR2, (récepteur de chimiokine pour CCL2), et montré qu'une diminution des Treg CCR2+ circulants chez les patients atteints de CECO était associée à une augmentation des Treg CCR2+ dans le TME. Enfin, en étudiant les structures lymphoïdes tertiaires (TLS), décrites dans le TME de divers cancers solides mais très peu dans les CECO, nous avons confirmé qu’ils étaient présents dans ces cancers et que de fortes densités de TLS sont principalement associées aux stades précoces du cancer et sont des facteurs de bon pronostic. / Oral squamous cell carcinomas (OSCC) represent about 25% of Head and Neck Cancer (HNSCC). They are associated with a very poor prognosis with a 10-year survival which not exceeds ~30%. While the Human Papilloma Virus (HPV) is a more recognized risk factor for oropharyngeal HNSCC, HPV is not involved in OSCC whose the main risk factors are related to the consumption of alcohol and tobacco. However, an increase of OSCC in patients who are not exposed to alcohol and tobacco (non-smoker-non-drinker: NSND) and whose the HPV status is negative is now reported. It is well known that immune tumor microenvironment (TME) may play a major role in tumor progression and tumor escape. Whether OSCC in NSND patients are epidemiologically different from OSCC occurring in smoker/drinker (smoker-drinker: SD) patients, and may have different immune composition of their TME and of circulating immune cells as well is addressed in this thesis. Thus in a first part, we studied a retrospective cohort of 553 OSCC patients and compared clinical and epidemiological parameters between NSND and SD patients. Then, we have prospectively studied in relation to risk factors these two entities from an immune point of view by analyzing blood and tissue samples from 87 patients and comparing them to tissue and blood samples from healthy controls (HD). Our work has allowed to associate this clinical heterogeneity with distinct immunological profiles that may predict different prognosis for NDNS or SD patients: since OSCC are inflammatory cancers presenting an important infiltrate of various innate immune components, it turned out that blood count of CD8+ T cells >306/µL in NSND and blood count of regulator T cells (Treg) >47/µL in SD patients were associated with a better disease free survival (DFS), respectively. By contrast, higher percentage of Th17 cells in the blood or TME from SD patients were associated with a bad DFS. In a third part of this thesis, we studied the migration of a Treg subset that expressed CCR2, a chemokine receptor for CCL2, and showed that a decrease of circulating CCR2+ Treg in OSCC patients was associated with an increase of CCR2+ Treg in the TME. Finally, by studying tertiary lymphoid structures (TLS) that have been described in the TME of various solid cancers but very few in OSCC, we confirmed that TLS are present in OSCC cancers and that high densities of TLS are mainly associated with early stages of cancer and are factors of good prognosis.

Objectives: The aims of this study was to investigate the RC microbiota in CCF canine teeth in the domestic dogs (Canis familiaris) and cheetahs (Acinonyx jubatus), identify the possible factors related to the presence of aerobic or anaerobic bacteria and evaluate and evaluate antibiotic susceptibility of bacteria isolated. Animals: Thirty nine animals suffering from CCF of their canine teeth were included in this study, of which 20 were dogs and 19 were cheetahs. Procedures: Evaluation of the oral cavity of animals while under general anaesthesia was performed and those without necrotic pulps or those that had received antibiotic therapy in the previous two weeks were excluded. Microbial samples were taken from 63 RC of which 27 were from dogs and 36 were from cheetahs. Strict anaerobic and aerobic techniques were used in parallel for plating, incubation and identification of the bacteria isolated in this manner. In an attempt to evaluate the sensitivity of the culture media and anaerobic technique used, additional samples were collected after the samples for bacterial isolation had been taken from the last eight pulps. These comprised those from six cheetahs and two dogs and were analysed using culture techniques and an initial screening with the 16S rRNA-specific PCR. Results: • Dogs: A total of 49 cultivable isolates were recovered belonging to 19 different bacterial species and 13 different genera. Individual RC yielded a maximum of four bacterial species. Of the bacterial isolates, 4.08 % were strict anaerobes, being represented by Clostridium acetobulitycum (2.04 %) and Prevotella melalinogenica (2.04 % ). The incidence of aerobic bacteria and facultative anaerobic bacteria in this study were 18.36 % and 77.56 %respectively of all the bacterial isolates. Of these Pasteurella multocida ( 10.20 % ), Corynebacterium spp. (10.20 %), Moraxella spp. (8.17 %), Bacillus spp. (6.12 %), Aeromonas salmonicida (6.12 %), Escherichia coli (6.12 %) and Pseudomonas aeruginosa (6.12 %) were the bacteria most frequently isolated. In summary, the RC microflora was found to be predominantly Gram negative facultative anaerobic microorganisms. The antibiotic agents that showed the highest efficacy in vitro against the different bacteria isolates were Enrofloxacin (85.21 % ), Gentamicin (92.39 %), Chloramphenicol (89.13 %). • Cheetahs: A total of 59 cultivable isolates, belonging to 19 different microbial species and 13 different genera were recovered from 36 RC sampled. Thirty-two (54.49 %) of the cultivable isolates were Gram positive while 27 (45.71 %) were Gram negative. Individual root canals each yielded a maximum of six species. Four RC had no cultivable bacteria. The bacterial micro flora recovered from the RC of the animals showed a higher number of facultative anaerobes (62.72 % of all the bacterial isolates). Aerobic isolates were 28.81 %, and strict anaerobes 8.47 % of all the isolates. The latter species comprised Clostridium sordelli (5.08 % ), and Clostridium septicum (3.38 % ). The species with the highest isolation frequency were Bacillus spp. (22.13 %), Pasteurella multocida (10.16 %), Corynebacterium spp. (8.47 %), Enterococcus spp. (8.47 %), Moraxella spp. (8.47 %) and Pseudomonas aeruginosa (5.25 %). In summary, the bacteria isolated from the RC were Gram positive facultative anaerobic bacteria. The antibiotics, which showed the highest efficacy in vitro against the different bacteria isolates, were Enrofloxacin (91.96 %), Gentamicin (86.37 %) and Orbifloxacin (86.28 %). • Nucleic Acid-Base detection: In dogs, Gram negative and Gram positive bacterial species were equally represented. Anaerobic bacterial species predominated at 83.3 % (5/6) of the species detected. On the other hand, in cheetahs, the bacterial species isolated by the PCR method showed a prevalence of anaerobic bacteria (60.8 %, 14/23), while facultative anaerobes were isolated in 30.2 % (7 /23) of cases and aerobic bacteria in 8.6 % (2/23). Conclusions and Clinical Relevance: This study has indicated that the microbial flora in any single infected RC is much more diverse than it has been shown using cultural techniques alone and can contain potentially uncultivable bacterial species. Some of these species may represent potentially new phylotypes, which may be involved in endodontic infections and ultimatelyin periradicular periodontitis, and should therefore be considered in any future studies involved in defining endodontic pathogens. Copyright / Dissertation (MSc)--University of Pretoria, 2012. / Companion Animal Clinical Studies / restricted

The objective was to determine if a correlation exists between Streptococcus mutans and DMFT in the oral cavity. This study examined the feasibility of microbial screenings as an additional caries predictor tool. The sample included 108 participants (ages 18-25) in low, moderate, and high socioeconomic groups. Subjects were selected from one dental clinic and one college in Virginia. Subjects were assessed for DMFT, salivary and plaque bacterial load, and CRA. Salivary load positively correlated with the DMFT. Plaque bacterial load and CRA negatively correlated with DMFT. Comparison of salivary bacterial load among economic levels showed higher bacterial loads with lower economic level only. Twice the observed values were found in the low socioeconomic level with CRA. DMFT and economic level showed differences between economic levels. Microbial screenings may be a useful, additional tool in determining caries risk in oral hygiene programs for all income populations.