Orientador: Ricardo Samih Georges Abi Rached / Banca: Silvana Regina Perez Orrico / Banca: Regina Maria Barretto Cicarelli / Banca: Francisco Humberto Nociti Junior / Banca: Márcio Zafallon Casati / Resumo: O objetivo do presente estudo foi avaliar o efeito da combinação do fator de crescimento de fibroblastos básico (b-FGF) e fator de transformação de crescimento beta (TGF- beta) na proliferação, expressão de genes para colágeno tipos I e III, metaloproteases -1 e -2 e TIMPs 1, 2 e 3, e na síntese destes próprios fatores de crescimento pelas células do ligamento periodontal de humanos. A avaliação da proliferação celular foi realizada após os períodos de 24 e 48h na presença dos fatores de crescimento, através da mensuração do nível de MTS reduzido a formazan pelas células viáveis, e a síntese de b-FGF e TGF-b pelo teste ELISA empregando a técnica "sandwich". Conclui-se que as associações do bFGF e do TGF-b atuaram de maneira dose-dependente no estímulo à proliferação celular, o aumento na expressão de genes para colágeno e TIMPs e redução para as metalproteases e modulação da síntese deles próprios. / Abstract: The aim of this study was to evaluate the effect of association of basic fibroblast growth factor and transforming growth factor beta on the proliferation, expression of colagen type I e III, matrix metalloproteinases-1 e -2 e TIMPs 1, 2 e 3, and on the modulation of the syntheses oh these growth factors by humans periodontal ligament cells. The cellular proliferation was evaluated to 24 and 48 hours of incubation by the colorimetric method. The synthese of bFGF and TGF-ß was verificated by ELISA method, using a "sandwich" techinique, and mRNA expression by Real Time - PCR. In conlusion, the associations of bFGF e TGF-ß influenced of dose-dependent manner on the cellular proliferation, on the increasing of the expression to collagen and TIMPs, and on the reduction to metaloproteinases and, the modulation of these own synthesis. / Doutor

Submitted by Renata Lopes (renatasil82@gmail.com) on 2017-03-24T19:12:52Z No. of bitstreams: 1 jessicadoamaralbastos.pdf: 1006529 bytes, checksum: b3c22bd9504dc4480527e616b99836a2 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2017-03-27T17:56:07Z (GMT) No. of bitstreams: 1 jessicadoamaralbastos.pdf: 1006529 bytes, checksum: b3c22bd9504dc4480527e616b99836a2 (MD5) / Made available in DSpace on 2017-03-27T17:56:07Z (GMT). No. of bitstreams: 1 jessicadoamaralbastos.pdf: 1006529 bytes, checksum: b3c22bd9504dc4480527e616b99836a2 (MD5) Previous issue date: 2009-08-03 / CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Periodontite crônica (PC) é uma doença inflamatória causada por bactérias Gram negativas que causam destruição dos tecidos de suporte do dente e tem sido considerada fator de risco não tradicional para a doença renal crônica (DRC). No presente estudo, realizado em portadores de PC, a frequência dos principais patógenos periodontais identificados em pacientes com DRC foi comparada com os detectados em indivíduos sem doença sistêmica. Foram avaliados 19 indivíduos com PC e sem evidências de doença sistêmica (grupo controle), 25 pacientes com PC e com DRC em estágio pré-dialítico (grupo pré-diálise) e 22 pacientes com PC e DRC em terapia renal substitutiva (grupo TRS). A gravidade da PC baseou-se na profundidade de sondagem (PS) e no nível de inserção clínica (NIC). O estadiamento da DRC baseou-se nos critérios do Kidney Disease Outcome Quality Initiative. A filtração glomerular (FG) foi estimada pela equação do Modified Diet in Renal Disease e a identificação dos microrganismos na placa subgengival foi realizada pela técnica de reação em cadeia da polimerase. Entre os microrganismos identificados, a C. albicans e P. gingivalis foram mais frequentes, respectivamente, nos pacientes em TRS (72,7% e 100%) e pré-diálise (52% e 94,7%) do que nos pacientes sem doença sistêmica (26,3% e 72,2% ), p< 0,05. Nos pacientes com PC e DRC, tanto nos estágios pré-dialíticos quanto em TRS, a presença de P.gingivalis, T.denticola e C. albicans se associou com níveis mais elevados de NIC comparativamente aos indivíduos sem doenças sistêmicas. Também observou-se maior gravidade da PC nos pacientes com DRC tanto nos estágios pré-dialíticos quando sujeito a tratamento dialítico. Nos pacientes com DRC, a PC é mais grave e se associa com maior frequência de C. albicans e P.gingivalis. / Chronic periodontitis (CP) is a destructive inflammatory disease of the supporting tissues of the teeth caused by Gram-negative bacterias and has been considered as a non traditional risk factor for chronic kidney disease (CKD). In this study, done in patients with CP, the frequency of the main periodontal pathogens were compared in patients with CKD and health individuals. Material and Methods: Ninetheen with no evidence of systemic disease (control group) with CP, 25 patients with CP and CKD not yet on dialysis (pre-dialysis group), and 22 patients with CP and CKD on dialysis (RRT group) were studied. The severity of the CP was based on probing pocket depth (PPD) and clinical attachment level (CAL). CKD was defined and staged as recommended by Kidney Disease Outcome and Quality Initiative. The glomerular filtration rate was estimated with the equation of Modified Diet in Renal Disease. The polymerase chain reaction was used in the identification of oral microrganisms. Candida albicans and Porphyromonas gingivalis were more frequently identified in patients with CP and CKD in RRT (72,7% and 100%) and in the pre-dialysis stages (52% and 94,7%) than in health individuals (26,3% and 72,2%) (p <0,05). In patients with elevated CP and CKD, in the pre-dialysis and RRT groups, the presence of P.gingivalis, T.denticola e C. albicans was associated with elevated index of CAL measurements comparing to the individuals without no evidence of systemic disease. It was also observed that the CP was more severe in the CKD patients than in the health controls. In patients with CKD, the CP is more severe and is due more frequently to Candida albicans and Porphyromonas gingivalis.

published_or_final_version / Dentistry / Master / Master of Dental Surgery

published_or_final_version / abstract / Dentistry / Master / Master of Dental Surgery

El objetivo del presente estudio fue determinar la relación que existe entre la severidad de la inflamación gingival de las adolescentes y adultas embarazadas. Para dicho propósito se evaluó a 120 pacientes de las cuales 48 fueron adolescentes (en dos grupos etáreos: 14-17 y 17-19) y 72 adultas (en tres grupos etáreos: 20-24; 25-29 y 30-35), divididas según trimestre de embarazo. Los parámetros clínicos a evaluar fueron índice gingival de Löe y Sillnes e índice de placa de Sillnes y Löe. Los resultados mostraron que la severidad de la inflamación gingival fue mayor en adolescentes que en adultas embarazadas. El mayor promedio del índice gingival fue para adolescentes con diferencias estadísticamente significativas, el mayor promedio de índice de placa fue para adolescentes con diferencias estadísticamente significativas, al evaluar los promedios del índice gingival de pacientes con índice de placa menor o igual a uno también el mayor promedio fue para adolescentes pero sin diferencias estadísticamente significativas. / The purpose of the present study was to determine the relation that exists between the severity of the gingival inflammation of the pregnant adolescents and pregnant adults. For this intention 120 pregnant women were evaluated of who 48 were adolescent (in two age groups: 14-17 and 17-19) and 72 adult (in three age groups: 20-24; 25-29 and 30-35), divided according to trimester of pregnancy. The clinical parameters to evaluate were Löe and Sillnes gingival index and Sillnes and Löe plaque index. The results showed that the severity of the gingival inflammation was greater in pregnant adolescents than in adults. The greater average of the gingival index was for adolescents with statistically significant differences, the greater average of plaque index was for adolescents with statistically significant differences. When evaluating the gingival index averages of patients with plaque index lower or equal to the one also greater average was for adolescents but without statistically significant differences.

Objetivo: Determinar el consumo de marihuana y características clínicas del tejido periodontal en pacientes del Centro de Rehabilitación “Fuente de Agua Viva”. Material y métodos: Estudio descriptivo y transversal. La muestra estuvo conformada por 60 pacientes del Centro de Rehabilitación “Fuente de Agua Viva” cuyas edades fluctuaban entre 18 a 50 años. Resultados: Se encontró que la frecuencia más alta de consumo de marihuana fue más de 2 veces al día, el tiempo de consumo entre 1 a 5 años y la forma de consumo más usada fue el cigarrillo. La mayor cantidad de pacientes no presentaron bolsa periodontal (86.7%), ni sangrado gingival (51.7%) pero sí un nivel de adherencia clínica leve (60%) y moderado (33.3%). Además el 96.7% no presentaron compromiso de furca; el 96.7% no tenían movilidad dentaria, el 81.7% presentaron agrandamiento gingival, el 78.3% recesión gingival, y el 63.3% de los pacientes un nivel de higiene oral regular. Conclusión: La enfermedad periodontal ha sido definida desde el punto de vista etiológico, como una patología multifactorial, donde la placa bacteriana actúa como agente principal y otros factores, de riesgo o predisponentes, actúan contribuyendo a aumentar las probabilidades del individuo de contraer la patología. En nuestro estudio se encontró que a pesar de que la frecuencia más alta de consumo (más de 2 veces al día), el tiempo de consumo (entre 1 a 5 años) y la forma de consumo más usada (el cigarrillo) se evidenció que la mayoría de pacientes presentaban un nivel de adherencia clínica promedio leve, moderado, ausencia de bolsa periodontal, sangrado gingival, movilidad dentaria y compromiso de furca, además el nivel de higiene oral fue regular. Por lo tanto no se puede asegurar que la marihuana ocasione directamente daños sobre el tejido periodontal, sino que existen otros factores que contribuyen a la modificación de los resultados. Palabras clave: Drogas, consumidores, marihuana, adicción, enfermedad periodontal. / Objective: To determine the consumption of marijuana and clinical features of periodontal tissue in patients of the Rehabilitation Center "Fuente de Agua Viva." Material and Methods: Descriptive and transversal. The sample consisted of 60 patients of the Rehabilitation Center "Fuente de Agua Viva” whose ages ranged from 18 to 50 years. Results: We found that the highest frequency of consumption of marijuana was more than 2 times a day, time of consumption between 1 to 5 years and the consumption of cigarettes was used. The largest number of patients had no periodontal pocket (86.7%) and gingival bleeding (51.7%) but a slight degree of adherence clinic (60%) and moderate (33.3%). Besides the 96.7% showed no commitment to furca; the 96.7% had no dental mobility, the 81.7% presented gingival, gingival recession, the 78.3% and 63.3% of patients a level of regular oral hygiene. Conclusion: Periodontal disease has been defined in terms of etiology, as a multifactorial disease, where plaque acts as master and other factors, or predisposing risk, helping to improve the act of the individual probabilities of contracting the disease. Our study found that although the highest frequency of consumption (more than 2 times a day), time of consumption (between 1 to 5 years) and the most widely used form of consumption (smoking) demonstrated that Most patients had an average level of adherence clinic mild, moderate, absence of periodontal pockets, gingival bleeding, tooth mobility and furcation commitment to further the level of oral hygiene was regular. Therefore there is no assurance that marijuana causes direct damage to periodontal tissues, but there are other factors contributing to the change in the results. Keywords: Drug consumers, marijuana addiction, periodontal disease.

El presente estudio tuvo como objetivo principal determinar la influencia de la terapia anticonceptiva hormonal oral (de contenido 0,3 ing de Norgestrel y 0,03 mg de Etinilestradiol) sobre los niveles de inflamación gingival. La muestra estuvo conformada por 60 mujeres sanas de 20 a 24 años de edad que fueron distribuidos en tres grupos ; un primer grupo de 20 mujeres consumidoras de anticonceptivos hormonales orales, con anterioridad de 2 años con tratamiento periodontal; un segundo grupo de 20 mujeres consumidoras de antíconceptivos hormonales orales, con anterioridad de 2 años sin tratamiento periodontal y un tercer grupo de 20 mujeres no consumidoras de anticonceptivos hormonales orales y con tratamiento periodontal. Este es un trabajo de investigación descriptivo, cuasi-experimental, comparativo., transversal y retrospectivo; encontrando que existe una diferencia significativa en cuanto a la inflamación gingival entre nuestros tres grupos, con lo cual podemos concluir que la ingesta de anticonceptivos por más de 2 años incrementa los niveles de inflamación gingival, si esta medicación hormonal oral es asociada al aumento de la placa bacteriana va incrementar los niveles de gingivitis.

En la actualidad, es frecuente el uso de fármacos bloqueantes de canales de calcio, ya que son útiles para tratar distintas patologías cardiacas como la angina inestable, angina estable crónica, arritmias supraventriculares, infarto agudo de miocardio, enfermedad isquémica del corazón y además, de manera efectiva , la hipertensión arterial, la cual afecta a la cuarta parte de la población mundial38. Éstos fármacos tienen la ventaja de poseer bajo costo, alta disponibilidad y efectividad3; sin embargo, poseen diversos efectos secundarios, como el agrandamiento gingival, el cual se ha reportado también como efecto colateral de la ciclosporina y algunos anticonvulsivantes, principalmente fenitoína. Esta alteración gingival tiene también otras etiologías relacionadas a las condiciones sistémicas, ya sean patológicas o fisiológicas. Dentro de las condiciones patológicas, están la enfermedad periodontal, enfermedades de fondo, como la leucemia, tumores, etc.; o algunas condiciones fisiológicas pueden predisponer a desarrollar agrandamiento gingival, como las alteraciones hormonales durante la pubertad, embarazo, etc. Este aumento del volumen de las encías acarrea problemas, no solo estéticos, sino también dificultades para un cepillado dental adecuado, lo cual produce una enfermedad periodontal combinada si el paciente no es meticuloso durante su higiene bucal. En algunos casos, puede traer también problemas funcionales, pues si el aumento del tamaño gingival es severo, puede dificultar la masticación. El agrandamiento gingival por fármacos se manifiesta solo en algunas personas, quienes tienen factores de riesgo, los cuales pueden ser relacionados con la dosis del fármaco, factores demográficos e influencia de la higiene dental. El objetivo del presente estudio fue determinar la prevalencia del agrandamiento gingival por bloqueantes de canales de calcio y evaluar su relación con el género del paciente, edad y arcada más afectada. Es importante que tanto el odontólogo, como el médico cardiólogo, tengan conocimiento de estas alteraciones para prevenirlas o diagnosticarlas de manera temprana.

Periodontitis is a chronic inflammatory disease that affects over 116 million adults in the United States. A shift in the normal microflora occurs as periodontal disease develops resulting in a larger number of Gram-negative anaerobes and spirochetes. An increase in the oral spirochete, Treponema denticola, is highly correlated with periodontal disease progression and severity. The ability of this periopathogen to thrive in the subgingival crevice is dependent on complement evasion mechanisms. Earlier analyses demonstrated that the primary mechanism of T. denticola serum resistance is binding of the human complement regulatory protein, Factor H (FH), to the factor H-binding protein (FhbB). FH serves as cofactor in the Factor-I mediated cleavage of C3b and accelerates the decay of the C3 convertase complex, leading to downregulation of C3b production. Several pathogens bind FH, and a number of these bacterial binding proteins have been shown to bind plasminogen. Plasminogen is a plasma glycoprotein that circulates as a zymogen. Its active form, plasmin, degrades components of the extracellular matrix and cleaves complement proteins C3b and C5 inhibiting complement pathway progression. Through molecular and biochemical analyses, this study demonstrates that FhbB simultaneously binds plasminogen and FH to residues located on its positively and negatively charged surfaces, respectively, and that the two ligands do not compete for binding. This study also shows that the surface-bound plasminogen is available for proteolytic cleavage into the active serine protease plasmin. The activated plasmin could break down components of the periodontal tissue leading to increased nutrient availability and creation of a larger anaerobic environment where the bacteria can flourish, thereby promoting periodontal disease.

Periodontitis is a chronic inflammatory disease initiated by gram negative anaerobic bacteria. These bacteria possess pathogen-associated molecular patterns (PAMPs) that interact with various receptors including Toll like receptors (TLRs). Bacterial DNA (bDNA) is one of the PAMPs mainly recognized by TLR9. Interaction of bDNA and its receptors leads to activation of inflammatory signaling pathways potentially resulting in periodontal bone destruction. The aim of this study was to determine the production of IL- 6 and IL-8 in response to periodontal bDNA from human osteoblastic cells (MG-63). MG- 63 cells were stimulated in duplicate for 20 hours with 100ng/μl of bDNA from various pathogens including Porhyromonas gingivalis, Esherichia coli, Streptococcus sanguinis, Aggregatibacter actinomycetemcomitans as well as heat killed whole bacteria (1:100). E.coli LPS (10ng/μl) was used as a positive control in each experiment. To block TLR9 signaling, further experiments were carried out by treating MG-63 cells with chloroquine (10ng/μl) for 2 hours at 37ºC prior to stimulations. Cytokine levels were determined using enzyme linked-immunosorbent assay. Although IL-6 and IL-8 production was increased in response to periodontal bDNA in MG-63 cells, the results were not significant compared to unstimulated controls. As expected, E.coli DNA, E.coli LPS and heat killed whole bacteria stimulated significantly increased cytokine production (p<0.05). Blocking TLR9 with chloroquine did not affect the amount of cytokine production in bDNA stimulated cells suggesting that TLR9 may not be operant in triggering IL-6 and IL-8 production from MG- 63 cells. In conlusion, periodontal bDNA did not trigger significantly increased IL-6 and IL-8 production from MG-63 cells. Considering the involvement of several inflammatory mediators in periodontal bone destruction, further studies are warranted to assess the production of other cytokines in response to periodontal bDNA in human osteoblastic cells.