Introduction: Root resorption is an undesired but frequent side effect of orthodontic treatment. Several studies have already aimed to evaluate the performance of CBCT on this topic. However, none have addressed the peculiarities of the most common daily orthodontic scenario. The aim of the study was to evaluate the influence of CBCT scans on the diagnosis of artificial external root resorption in the apical third of anterior teeth. Materials and methods: One hundred extracted human anterior teeth were randomly assigned to 2 uneven groups (51 as the control and 49 as the experimental group). A limited area of the apical third of the root of the teeth of the experimental group was selected and a buffer solution was used to induce tooth subsurface demineralization. Before CBCT image acquisition, each tooth was coated with an approximately 0.3 mm thick layer of utility wax to simulate the radiographic appearance of the periodontal space and placed into an empty mandibular anterior socket of a partially edentulous dry human mandible. The mandible was placed into a polystyrene box filled with water prior to the CBCT examination to simulate soft-tissue attenuation and scattering. The CBCT images were obtained on an i-CAT unit (i-CAT Next Generation, Imaging Sciences International, Hatfield, PA) according to three protocols: (I) half scan (180°), 0.40 mm voxel size; (II) full scan (360°), 0.40 mm voxel size; and (III) full scan (360°), 0.125 mm voxel size. The 300 resultant CBCT DICOM volumes were imported into InVivo software (InVivo5, Anatomage, San Jose, CA) for evaluation by three blinded, previously calibrated observers using a five-point confidence rating scale. Cohen’s kappa was used to calculate observers’ agreement. The diagnostic values of sensitivity (Sn), specificity (Sp) and accuracy (Ac) were performed by pooling observer responses for every image modality. Receiver operating characteristic (ROC) were built and the areas under the curve (AUC) were calculated. The Sn, Sp and Ac values were compared by Cochran’s Q test. The AUC values were compared by Mann-Whitney U test. Results: The observers’ agreement ranged from 0.63 to 0.71, which was interpreted as a substantial agreement. Protocol III (0.125 mm voxel size) displayed the highest Sn (81.63 %), Ac (80.67%) and AUC (0.807). There were statistically significant differences between protocol III and the other two protocols (p < 0.001). The specificity of protocol I (84.97 %) was greater than that of protocols II (69.93 %) and III (79.74 %); however statistically significant difference was only found between protocols I and II (p = 0.005). Conclusion: Although there was no difference in accuracy between the degrees of rotation (half and full scan) within the same voxel size (0.4 mm), there was a considerable difference between those and the smallest voxel size (0.125 mm). In fact, it may be suggested that a more dedicated, high resolution scan should be acquired when one intends to investigate the early stage of external root resorption during orthodontic treatment.

>Magister Scientiae - MSc / Periapical lesions are fairly common pathology associated with the apex of a non-vital tooth. Some chronic lesions develop without an acute phase with no recollection of previous symptoms. It is known that maxillary odontogenic infections can breach the sinus floor with succeeding complications. Pantomography, a widespread conventional radiographic technique, provides a generalized view of the maxillofacial region. Advanced modalities like CBCT may facilitate in navigating complex anatomy, which would otherwise be obscured.

E-cigarette (e-cig) use is rising, but much is unknown about the effects of its vapor. This vapor contains chemicals such as propylene glycol, a known antimicrobial, and nicotine, whose derivatives are carcinogenic. Here, we study the effects of vaping on resident bacteria of the oral cavity and on oral cell inflammation. Oral streptococci are major residents in the oral cavity, with S. mutans the primary cause of dental caries. Growth and biofilm formation have been shown to be enhanced upon exposure to traditional cigarette smoke in vitro. In this study, we analyzed the effects of e-cig vapor on growth and biofilm formation in S. mutans, S. sanguinis, and S. gordonii. Organisms and oral epithelial cells were treated using nicotine-free and 3mg nicotine vapor, as well as double-shot menthol freeze flavored 3mg nicotine vapor in a vape chamber designed to phenocopy physiologically relevant exposure. Nicotine-independent inhibition of growth occurred upon exposure in all three bacterial species. Interestingly, biofilm formation was enhanced in the S. mutans while decreased in S. sanguinis and S. gordonii. Epithelial cells showed activation of survival pathways by Western Blot upon exposure to only e-cigarette vapor as well as co-culturing of bacterial and oral epithelial cells at a multiplicity of infection of one The pioneer colonizers S. gordonii and S. sanguinis generally antagonize caries-causing S. mutans, which can become a predominant member of the community under appropriate conditions, leading to dental caries formation. The observed decrease in the biofilm formation of the commensals S. sanguinis and S. gordonii upon e-cig vapor exposure indicates the opportunistic colonization of S. mutans, whose biofilm-forming abilities increased. Following e-cig usage, dental caries and cancer in the oral epithelium may result from this dysbiosis of the microbiome.

The objective of this study was to evaluate the biofilm removal efficacy of three root canal treatment systems: ProUltra® PiezoFlow™, traditional needle irrigation, and the GentleWave® system in an ex-vivo benchtop study. Twenty-four extracted maxillary and mandibular molars were selected. Teeth were all instrumented to a master apical file size #25 with 4% taper. Teeth were then randomly divided into four experimental groups and two control groups. The root canals were inoculated with a culture of Enterococcus faecalis and incubated for five weeks to form a biofilm. Each group was then treated with one of the different root canal treatment systems using 6% sodium hypochlorite (NaOCl) as per the respective manufacturer’s recommendation followed by a rinse with water. Following treatment, teeth were decoronated and roots were sectioned longitudinally. Three scanning electron microscope images were taken at the apical level per root half at 5000x magnification. Images were scored by four calibrated examiners blind to group membership using a four-point scoring system (<5% coverage, 5-33%, 34-66%, and >66%). Results were analyzed using mixed model ANOVA. All the experimental groups were significantly better than the positive control group in removing biofilm. Among the experimental groups, the GentleWave® 15/04 group was significantly better than the other groups. There was no significant difference between the GentleWave® and the ProUltra® PiezoFlow™. Traditional needle irrigation scored the worst in reducing E. faecalis biofilm. The GentleWave™ system was as effective at intracanal biofilm removal as the ProUltra® PiezoFlow™ and better than traditional needle irrigation using 6% NaOCl as an irrigant.

Objective: The goal of the present study was to investigate the effect of chairside surface treatments on biaxial flexural strength and subsurface damage of monolithic zirconia ceramics. Methods: Specimens (15x15x1.2 mm3) were prepared by sectioning from commercially available zirconia blanks (BruxZirTM) and sintering according to manufacturer's recommendations. Fully dense specimens were randomly divided into five groups (n=30) and treated as follows; 1) as-sintered (AS) 2) air abraded with 50 μm alumina fine particles (AAF), 3) air abraded with 250 μm coarse alumina particles (AAC), 4) ground (G), and 5) ground and polished (GP) to mimic chairside and dental laboratory treatments. Microstructural changes were thoroughly characterized by optical and scanning electron microscopy, surface profilometry and atomic force microscopy. Crystalline phases and their depth profile were investigated by x-ray diffraction (XRD) and grazing incidence x-ray diffraction (GIXRD). Results were analyzed by Kruskal-Wallis test and Tukey's adjustment for multiple comparisons. A 0.05 level of significance was used. Reliability was evaluated by Weibull analysis. Results: All treatment groups exhibited a significant difference in mean surface roughness (Rq) compared to the as-sintered group (p<0.05). The AAC group showed the highest surface roughness at 1.08 ± 0.17 μm, followed by the G, AAF and AS groups. The GP group exhibited the lowest surface roughness. The group air abraded with fine particles showed the highest mean biaxial flexural strength (1662.62 ± 202.58 MPa), but was not different from the ground and polished group (1567.19 ± 209.76 MPa). The groups air abraded with coarse particles or ground with diamond bur exhibited comparable mean biaxial flexural strength at 1371.37 ±147.62 MPa and 1356.98 ±196.77 MPa, respectively. The as-sintered group had the lowest mean biaxial flexural strength at 1202.29 ±141.92 MPa. The depth of compressive stress layer, measured by GIXRD was approximately 50 μm in the AAF group, followed by the AAC group with ~35 μm, ~10 μm for the ground group and ~5 μm for the ground and polished group. Deep subsurface cracks were observed in the AAC group (~80 μm in depth) and G group (~25 μm in depth), whereas shallower flaws were present in the AAF and GP groups at 10 and 3 μm, respectively. Weibull analysis represented a greater reliability in zirconia specimens treated with air abrasion groups. Conclusions: Surface treatments induced the t-m transformation in 3Y-TZP and associated development of compressive stresses to a depth that varied with the severity of the treatment performed. GIXRD revealed that AAF led to the thickest compressive stress layer, followed by AAC, G and GP. SEM revealed that subsurface damage was most severe with AAC, followed by G, AAF and GP. We propose that the flexural strength results can be explained by the difference between the depth of the compressive stress layer induced by the transformation and the depth of the subsurface flaws.

The facultative anaerobe, Escherichia coli and the obligate anaerobe, Porphyromonas gingivalis are two bacteria that reside in our body. Although they reside in separate environments, they are both subject to hydrogen peroxide stress and have mechanisms to regulate the stress. OxyR is the primary transcriptional regulator/sensor of oxidative stress response caused by hydrogen peroxide. OxyR in P. gingivalis is not well-characterized compared to OxyR in E. coli. We sought to characterize and compare the two forms of OxyR in order to gain a better understanding of the protein. We determined the oligomeric state of both proteins: primarily a tetramer for E. coli and primarily a tetramer for P. gingivalis OxyR.. We demonstrated DNA binding with E. coli OxyR, indicating purification of the functional form of E. coli OxyR.Through pulldown assays we discovered potential novel binding targets, mobB for E. coli OxyR and PG1209 for P. gingivalis OxyR. Many of the other targets corresponded to intergenic regions within genes, which may pertain to small RNAs or small proteins. These results show that OxyR in E. coli and P. gingivalis has novel function and properties indicating an expanded role in addition to the well-characterized oxidative stress response.

Biofilm accounts for 65%-80% of microbial infections in humans. Considerable evidence links biofilm formation to oral disease and consequently systemic infections. Eradication of biofilm-associated infections is important. Streptococcus sanguinis, a Gram-positive bacterium, is one of the most abundant species in oral biofilm. It contributes to biofilm development in oral cavities and is one of the recognized causes of infective endocarditis. To study and identify biofilm genes in S. sanguinis, biofilm formation of 51 mutants was compared with the wild type SK36 strain using crystal violet (CV) staining in a microtiter plate. Confocal laser scanning microscopy (CLSM) and image analysis was done to compare biofilm formation by the mutant to the wild type SK36 strain. A biofilm mutant XG2_0351, encoding a type I signal peptidase (SPase I), was further investigated. SPase I cleaves proteins that are transported through secretory machinery and is necessary for the release of translocated preproteins from a cytoplasmic site of synthesis to extracytoplasmic/membrane destinations. S. sanguinis, like many Gram-positive bacteria, has multiple SPases I. The objective of this project is to investigate the distinctive role that SPase I plays in biofilm formation in S. sanguinis. Using a plate reader, the growth curves of the wild type strain SK36 and XG2_0351 were compared. The scanning electron microscope (SEM) was utilized to compare the cell surface morphologies. Coomassie staining was done to narrow the list of potential substrates of XG2_0351. CV staining and CLSM images indicated phenotypic differences between the SPase I mutant and SK36. The growth curves of XG2_0351 and SK36 showed no significant difference although SEM illustrated a difference in the cell surface morphologies. Coomassie staining illustrated a number of substrates that were present in SK36 but not XG2_0351. In addition bioinformatics was used to understand the gene function. In conclusion, XG2_0351 reduces biofilm formation in S. sanguinis but further research is necessary to elucidate the specific proteins that are involved. Clarifying the vii role that SPase I plays in reduced biofilm formation in S. sanguinis will give a better understanding of the biofilm formation mechanism.

As lesões ósseas são doenças raras, mas com um grande destaque, que afetam a região maxilofacial. Dentre elas podemos destacar as Lesões Centrais de Células Gigantes e as Lesões Fibro-Ósseas Benignas (Displasia Cemento-Ossificante, Fibroma Ossificante e Displasia Fibrosa). O presente estudo teve como objetivo descrever e analisar os dados encontrados nas fichas de encaminhamento clínico presentes no Serviço de Patologia Oral e Maxilofacial da Faculdade de Odontologia da Universidade de São Paulo. Foram avaliados 89.265 casos em um período que variou de 1950 até 2016, utilizando as categorias de gênero, idade, etnia, sintomatologia, hipótese diagnóstica e localização anatômica. Após as exclusões, os casos selecionados somavam 773 casos divididos em: 267 casos de Lesão Central de Células Gigantes, 231 casos de Displasia Cemento Ossificante, 142 casos de Fibroma Ossificante e 133 de Displasia Fibrosa. Os resultados do estudo estão de acordo com o que está descrito na literatura, exceto nos casos de Displasia Fibrosa que foi encontrado uma predileção maior sexo feminino do que o masculino, mesmo que a literatura expresse que não existe tal predileção. Já nos casos de Displasia Cemento-Ossificante, o presente estudo mostrou que a maior prevalência de idade é entre a 4ª e 5ª década de vida e não entre a 3ª e 4ª como encontrado na literatura. Os casos de Displasia Cemento-Ossificante, em relação à etnia dos pacientes, mostraram que a maioria dos pacientes encontrados pelos autores eram leucodermas e não melanodermas como relata a literatura. Os resultados mostraram que mesmo em um centro de referência como o Serviço de Patologia Oral da Faculdade de Odontologia da Universidade de São Paulo, as lesões ósseas são raras e alguns fatores como idade em pacientes com Displasia Fibrosa e Displasia Cemento-Ossificante e etnia em pacientes com Displasia Cemento-Ossificante não correspondem ao encontrado na literatura mundial. / Bone lesions are rare but important diseases that affect the maxillofacial region. Among them we can highlight the Central Giant Cells Lesion and the Benign Fibro-Osseous Lesions (Cemento-Osseous Dysplasia, Ossifying Fibroma and Fibrous Dysplasia). The objective of this study was to describe and analyze the data found in the clinical referral forms present at the Oral and Maxillofacial Pathology Service of the Faculty of Dentistry of the University of São Paulo. We evaluated 89.265 cases in a period ranging from 1950 to 2016, using the categories of gender, age, ethnicity, symptomatology, diagnostic hypothesis and anatomical location. After the exclusions, the selected cases totaled 773 cases divided into 267 cases of Central Giant Cell Lesion, 231 cases of Cemento-Osseous Dysplasia, 142 cases of Ossyfing Fibroma and 133 cases of Fibrous Dysplasia. The results of the study are in agreement with what is described in the literature, except in the cases of Fibrous Dysplasia that a predilection was found greater female than the male, even if the literature expresses that there is no such predilection. In the cases of Cemento-Osseous Dysplasia, the present study showed that the highest prevalence of age is between the 4th and 5th decade of life and not between the 3rd and 4th as found in the literature. The cases of Cemento-Osseous Dysplasia, in relation to the ethnicity of the patients, showed that the majority of the patients found by the authors were white and not black as reported in the literature. The results showed that even in a reference center such as the Oral Pathology Service of the Faculty of Dentistry of the University of São Paulo, bone lesions are rare and some factors such as age in patients with Fibrous Dysplasia and Cement-Ossificante Dysplasia and ethnicity in patients with Cement-Ossific Dysplasia do not correspond to that found in the world literature.

Submitted by Sara Ribeiro (sara.ribeiro@ucb.br) on 2018-04-23T18:00:41Z No. of bitstreams: 1 JaquelineAlvesAlencarDissertacao2017.pdf: 1770580 bytes, checksum: bb5fec88a0c6eb31f21f5b864c0e0be8 (MD5) / Approved for entry into archive by Sara Ribeiro (sara.ribeiro@ucb.br) on 2018-04-23T18:00:59Z (GMT) No. of bitstreams: 1 JaquelineAlvesAlencarDissertacao2017.pdf: 1770580 bytes, checksum: bb5fec88a0c6eb31f21f5b864c0e0be8 (MD5) / Made available in DSpace on 2018-04-23T18:00:59Z (GMT). No. of bitstreams: 1 JaquelineAlvesAlencarDissertacao2017.pdf: 1770580 bytes, checksum: bb5fec88a0c6eb31f21f5b864c0e0be8 (MD5) Previous issue date: 2017-12-15 / Brazil undergoes a process of rapid and intense population aging, creating a concern about how to properly structure health services for the elderly. Many elderly patients present alterations in the oral cavity, due to the manifestations of systemic diseases, nutritional deficiencies, drug side effects, poorly adapted prostheses, little education about the importance of adequate hygiene, among other reasons. The purpose of this study was to verify the main types of lesions affecting the oral cavity of the elderly treated at a Gama Living Center. Intraoral and extraoral evaluation of 80 elderly people, with average age of 70 years, most of them female (71%). Many had oral lesions, with more prevalence of candidiasis (20%), intraoral exam and angular cheilitis (5%), on extraoral examination. It also presented a high CPO-D index, 50% of the sample with a total of 28 missing teeth, decayed and obturated, as well as inadequate hygiene and presence of lingual flap (75%). Demonstrating the importance of prevention, health care programs, specialized care and oral health orientation of the population evaluated. / O Brasil passa por um processo de envelhecimento populacional r??pido e intenso, criando-se a preocupa????o de como estruturar adequadamente os servi??os de sa??de para o idoso. Muitos pacientes idosos apresentam altera????es na cavidade bucal, em consequ??ncia das manifesta????es de doen??as sist??micas, defici??ncias nutricionais, efeitos colaterais de f??rmacos, pr??teses mal adaptadas, pouca instru????o sobre a import??ncia de uma higieniza????o adequada, dentre outras raz??es. Este estudo teve como prop??sito verificar os principais tipos de les??es que acometem a cavidade bucal de idosos atendidos em um Centro de Conviv??ncia do Gama, DF. Foi realizada a avalia????o intra e extraoral de 80 idosos, com idade m??dia de 70 anos, a maioria do g??nero feminino (71%). Muitos apresentaram les??es bucais, sendo mais prevalente a candidose (20%), no exame intraoral e a queilite angular (5%), no exame extraoral. Apresentou-se tamb??m um elevado ??ndice de CPO-D, 50% da amostra, com um total de 28 dentes perdidos, cariados e obturados, al??m de higiene inadequada e presen??a de saburra lingual (75%), demonstrando a import??ncia da preven????o, dos programas de aten????o de sa??de, atendimento especializado e de orienta????o em sa??de bucal da popula????o avaliada.

RESUMO A similaridade entre o tecido da mama e o da glândula salivar está bem estabelecida. A porção das estruturas acinares e ductais destes órgãos são basicamente semelhantes. Estes aspectos, associados ao fato de que uma coexistência de carcinomas da mama e de glândula salivar, têm sido relatados em uma incidência maior do que a esperada. Guiaram estudos tentando determinar a importância dos receptores de estrógeno e progesterona em adenomas pleomórficos (AP). A neoplasia é mais freqüente nas glândulas salivares e exibe uma predileção para o sexo feminino. Recentemente a presença do receptor de estrógeno (RE) e do receptor de progesterona (RP) tem sido investigada no AP, entre outras neoplasias de glândula salivar, questionando-se a possibilidade da existência da dependência hormonal. A expressão dos receptores hormonais nos carcinomas de mama é importante para determinar o prognóstico e a probabilidade de responder à manipulação hormonal. Neoplasias que apresentam positividade para ambos os receptores, estrógeno e progesterona, exibem maior probabilidade de resposta à terapia anti-estrogênica do que as neoplasias que são negativas para estes receptores. Baseando-se na literatura científica pertinente, o presente trabalho se propõe a investigar a presença da proteína RE e da proteína RP em APs humanos, relacionando-os com a proliferação de linhagens celulares sob a influência destes hormônios. A técnica utilizada foi a imuno-histoquímica para a pesquisa dos RE e RP em 10 APs emblocados em parafina pertencentes ao arquivo do Serviço de Patologia Cirúrgica da FOUSP, e de duas linhagens de APs estabelecidas no mesmo serviço: uma derivada de um paciente do sexo masculino e a outra de um paciente do sexo feminino. No meio de cultivo onde subculturas destas células proliferavam foram diluídos 17-b-estradiol e progesterona. Através de contagens destas células em períodos pré-determinados (24 horas, 48 horas e 72 horas), pretendeu-se verificar a influência dos respectivos hormônios na multiplicação celular. Como controle positivo utilizou-se uma linhagem denominada T-47D, que foi largamente estudada na literatura. A T-47D é derivada de um carcinoma metastático de mama, reconhecidamente hormônio dependente. E como controle negativo, utilizou-se de uma linhagem de carcinoma epidermóide, denominada HN30. Encontrou-se positividade para o RE em 7 de 10 APs estudados (4 em homens e 3 em mulheres) e positividade para o RP em 8 Aps estudados (4 em mulheres e 4 em homens). Pela análise estatística, constatou-se que existe uma diferença significativa no índice proliferativo entre o controle e as células submetidas à ação do 17-b-estradiol e da progesterona. Para a linhagem derivada do paciente do sexo masculino houve diferença entre o controle e as células expostas ao 17-b-estradiol e a progesterona somente nas últimas 72 horas. Para a linhagem derivada do sexo feminino constatou-se uma diferença significativa entre o controle e as células sob a influência da progesterona, a partir de 48 horas de proliferação celular. A diferença significativa entre o controle e as células sob a ação do 17-b-estradiol ocorreu somente a partir das 72 horas, sugerindo que o AP poderia ser uma neoplasia influenciada pela ação hormonal. / SUMARY It is well established the similarity between mammary and salivary glands especially between the acinic and ductile structures. These aspects, associated to the fact of coexistence of breast carcinomas and of salivary gland tumors been described, leaded studies in attempt to determine the importance of the ERs and Pr in pleomorphic adenomas (PA), the most frequent salivary gland tumor and with predilection for the females. Lately, the presence of ERs and of the PRs has been investigated in PA and other salivary gland tumors pointing out their hormonal dependency. The expression of hormone receptors in breast carcinomas is crucial to determine a presence for both receptors. These tumors exhibit better response to anti-estrogenic therapy than the negative ones. Basing on the pertinent scientific literature, the present study proposes to investigate the presence of the RE and of the RP in humans PA and connecting them with cellular proliferation in vitro, under the influence of these hormones. Immunohistochemistry technique was used for the detection of RE and RP in paraffin embedded 10 PAs from the files of the Department of Oral Pathology, School of Dentistry, University of São Paulo, and two PA cell lines one from a male patient and other female. The culture midia was supplied with, 17-b-estradiol and progesterone. A growth curve was performed (24 hours, 48 hours and 72 hours) to verify the influence of the respective hormones in the cellular proliferation. As a positive control T-47-D cells derived from a hormone dependent metastatic breast carcinoma were used, and as negative control HN30 cells, derived from a tongue squamous cell carcinoma. 7 of 10 PAs were positive (4 in men and 3 in women) for RP and 8 of 8 PAs (4 in women and 4 in men) for RE. The statistical analysis verified a significant difference in the proliferative index between the control cells and the ones submitted to the action of the 17-b-estradiol and of the progesterone: for male derived lineage a difference was only observed in the last 72 hours. In the other hand, for the female derived lineage a significant difference was verified starting from 48 hours, suggesting that PA can be influenced by hormonal action.