Introdução: a ausência de extensão completa do joelho é uma condição limitante que algumas vezes precisa ser tratada invasivamente através da realização da capsulotomia posterior do joelho, uma vez que medidas conservadoras tenham sido esgotadas previamente. No entanto, mesmo com a literatura vigente, ainda não está claro se o procedimento para aquisição de extensão do membro inferior está associado á melhora funcional de pacientes com contratura em flexão do joelho e queixas de dor anterior, bem como se este ganho de extensão pode ser mantido ao longo do tempo. Métodos: nós conduzimos um estudo de coorte retrospectivo de 21 pacientes com contratura em flexão mínima do joelho os quais foram submetidos à capsulotomia posterior do joelho por técnica aberta entre 1990 e 2010. Após 9.19 ± 6.68 anos de follow-up, os níveis funcionais do joelho e média de ângulo de contratura em flexão foram comparados com os dados pré-operatórios e a taxa de recorrência pôde ser estimada. Complicações investigadas incluíram instabilidade do joelho secundária ao procedimento e danos neurovasculares. Resultados: pré-operatoriamente, todos os pacientes (100%) apresentavam scores funcionais de Lysholm classificados como regular ou ruim (média absoluta do score 58.66 ± 13.87, 95%CI 52.35–64.98), e 15 pacientes (72%) apresentaram melhora funcional, com scores bom ou excelente (média de score de Lysholm 87.61 ± 8.81, 95%CI 83.60–91.63) após o período de follow-up. A média pré-operatória do ângulo de flexão do joelho foi de 25.04 ± 9.15 graus (95%CI 20.88–29.21) e diminuiu para 4.28 ± 4.18 graus (95CI% 2.38 – 6.19). Nenhum paciente apresentou complicações relacionadas ao procedimento Conclusão: baseado em nossos resultados, nós concluímos que a capsulotomia posterior do joelho parece ser um procedimento seguro e efetivo para tratar adequadamente pacientes com joelhos dolorosos secundários a contraturas em flexão, com uma baixa taxa de recorrência mesmo após 9.19 anos em média de seguimento. / Background: lack of full extension of the knee is a disabling condition that sometimes needs to be treated invasively by a posterior capsulotomy of the knee, since conservative treatments have been exhaustively attempted. However, it is not clear if the procedure is able to improve anterior symptoms on the knee of patients with flexion contracture and if the full extension acquired can be kept throughout long-time follow-up. Methods: we conducted a retrospective cohort study of 21 patients diagnosed with minimal flexion contracture of the knee who underwent open posterior capsulotomy between 1990 and 2010. After 9.19 ± 6.68 years of follow-up, knee function and mean angle of fixed knee flexion were compared to baseline data and the recurrence rate was estimated. Complications investigated included knee instability and neurovascular damages. Results: all patients (100%) presented with a preoperative Lysholm score classified as poor or fair (mean, 58.66 ± 13.87, 95%CI 52.35–64.98), but 15 patients (72%) experienced an improvement to good or excellent scores (mean, 87.61 ± 8.81, 95%CI 83.60–91.63) after long-time follow-up. The mean preoperative angle of fixed flexion was 25.04 ± 9.15 degrees (95%CI 20.88–29.21) and it decreased to 4.28 ± 4.18 degrees (95CI% 2.38 – 6.19, after the follow-up. Conclusion: Based on these results, we conclude that posterior capsulotomy of the knee proved to be a safe and effective procedure to treat properly patients with painful knees secondary to lack of full extension with a low rate of recurrence even after a long-term follow-up.

Afin d’effectuer un mouvement de la main, le système nerveux doit mettre en commun des informations issues de plusieurs sens : c’est l’intégration multisensorielle. Le cortex pariétal postérieur est une interface sensorimotrice qui est impliquée dans le processus d’intégration multisensorielle. Si cette région est endommagée, les patients présentent un trouble visuomoteur dénommé ataxie optique qui se caractérise par une difficulté à réaliser des mouvements visuellement guidés de la main. À ce jour, les mécanismes qui sous-tendent l’intégration multisensorielle pour l’action ne sont pas encore totalement connus. Le premier axe de ma thèse consiste à définir, chez les sujets sains, comment les informations visuelles et somatosensorielles sont intégrées pendant la planification d’un mouvement de pointage. Le deuxième axe s’intéresse aux troubles sensorimoteurs associés à l’ataxie optique qui permettent une meilleure compréhension des fonctions du cortex pariétal postérieur dans la planification motrice et le contrôle du mouvement. / To execute reach movements, the central nervous system needs to combine informationfrom different sensory modalities, a process knows as multisensory integration. Theposterior parietal cortex is a sensorimotor interface implicated in multisensory integrationprocesses. Patients with a damage to this region exhibit a visuomotor deficit called opticataxia. Patients with optic ataxia present difficulties in performing hand visually-guidedmovements. To date, the mechanisms underlying multisensory integration are still notfully understood. The first aime of my thesis is to determine how visual and somatosensoryinformation are integrated in healthy participants, during the planning of pointingmovements. I will then focus on the sensorimotor deficits observed in optic ataxia whichenable a better understanding of the functions of the posterior parietal cortex in motorplanning and online control.

No description available.

Made available in DSpace on 2014-06-11T19:26:07Z (GMT). No. of bitstreams: 0 Previous issue date: 2005-07-22Bitstream added on 2014-06-13T18:29:30Z : No. of bitstreams: 1 yokoo_mji_me_jabo.pdf: 499776 bytes, checksum: 3d550dd485aed2d91aac747fee888b70 (MD5) / Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) / Universidade Estadual Paulista (UNESP) / O objetivo do presente trabalho foi estudar os fatores genéticos e ambientais que afetam as características de carcaça, área de olho de lombo (AOL), espessura de gordura subcutânea (EG), e espessura de gordura subcutânea na garupa (EGP8), quantificadas por meio do ultra-som em bovinos da raça Nelore. Além disso, verificar as possíveis associações genéticas entre as características de carcaça, e dessas com peso, circunferência escrotal, padronizados aos 120 (P120), 210 (P210), 365 (P365 e CE365), 450 (P450 e CE450) e 550 (P550 e CE550) dias de idade e altura do posterior (ALT). O banco de dados foi composto por cerca de 22.778 animais machos e fêmeas, dos quais, aproximadamente 2.590 continham medidas de características de carcaça e ALT coletadas entre os anos de 2002 e 2004, com idades entre 450 e 599 dias, provenientes de dez fazendas de seis estados brasileiros. Para o estudo dos efeitos de ambiente sobre as características de carcaça, foi utilizada a metodologia dos quadrados mínimos, empregando-se modelos fixos, considerando os efeitos de fazenda, ano (AN) e estação de nascimento, sexo, manejo alimentar, e as covariáveis idade da vaca ao parto (IVP - efeitos linear e quadrático) e idade do animal (efeitos linear e quadrático para a AOL e linear para a EG e EGP8). Os parâmetros genéticos foram estimados em análises uni, bi e tri-caracteres utilizando máxima verossimilhança restrita. Todos os fatores de ambiente afetaram significativamente as características de carcaça, com exceção do AN que não influenciou EG e EGP8 e da IVP que não afetou AOL, de forma significativa. As estimativas de herdabilidade para AOL, EG e EGP8 foram de 0,29 ± 0,07, 0,50 ± 0,09 e 0,39 ± 0,08, respectivamente. Esses resultados indicam que as características de carcaça possuem alta variabilidade genética, podendo ser incluídas em programas de melhoramento genético... / The objective of this work was to study the genetic and environmental factors that affect carcass traits, longissimus muscle area (ULMA) backfat thickness (UBF) and rump fat thickness (URF) quantified using real-time ultrasound in Nellore cattle. Besides verifying the possible genetic associations among those traits and of those with weight and scrotal circumference standardized to 102 (W120), 210 (W210), 365 (W365 and SC365), 450 (W450 and SC450), and 550 (W550 and SC550) days of age and hip height (HH) on scan date. The data set was composed close to 22,778 male and female animals, of which, approximately 2,590 contained measures of carcass traits and HH collected between 2002 and 2004, with ages between 450 and 599 days and distributed on ten farms across six Brazilian states. The Least Squares methods was used to study the effect of environment on carcass traits, using a fixed model, considering farm, year and season of birth (YB and SB), sex and type of feed, besides the covariates, age of dam (AOD - linear and quadratic effects) and age of animal at measurement (linear and quadratic effects for ULMA and linear for UBF and URF). The genetic parameters were estimated in one, two and three-traits analyses, using restricted maximum likelihood. All environmental factors significantly affected carcass traits, with the exception of YB for UBF and URF and AOD for ULMA. The heritability estimates for ULMA, UBF and URF were respectively 0.29 ± 0.07, 0.50 ± 0.09 and 0.39 ± 0.08. These estimates indicate that carcass traits have high genetic variability, might be include beef improvement programs and should respond on individual selection quickly. The genetic correlations suggest that genetic progress may be achieved without producing antagonistic effects on weight and scrotal circumference. The selection for HH would likely produce animals that are late-maturing, in terms of carcass fat deposition.

L’oxaliplatine, anticancéreux utilisé pour le traitement du cancer colorectal, est responsable d’une neurotoxicité périphérique dose-limitante affectant une grande majorité de patients. La neurotoxicité de l’oxaliplatine se présente sous deux formes : une forme immédiate, se traduisant par des paresthésies transitoires, et une forme retardée et cumulative, caractérisée par l’apparition d’une neuropathie périphérique douloureuse fortement invalidante. A l’heure actuelle, la prise en charge des douleurs neuropathiques est souvent incomplète, principalement à cause du manque de traitements efficaces et bien tolérés. Dans ce contexte, il existe un réel besoin d’innovation thérapeutique pour améliorer le traitement de ces neuropathies, nécessitant au préalable une meilleure compréhension de leur physiopathologie. La première partie de ce travail porte sur l’évaluation de l’effet d’une alimentation sans polyamines sur l’apparition et la chronicisation de la neurotoxicité de l’oxaliplatine chez le rat. En effet, en modulant positivement la sous-unité NR2B des récepteurs NMDA, les polyamines alimentaires pourraient faciliter la sensibilisation douloureuse. Un régime sans polyamines a permis de prévenir l’hypersensibilité thermique et mécanique induite par l’oxaliplatine. Bien que ces symptômes nociceptifs ne soient pas associés à une augmentation de l’expression de la sous-unité NR2B au niveau spinal, l’ifenprodil (antagoniste NR2B spécifique) permet d’en diminuer l’intensité de manière dose-dépendante. Enfin, une étude métabolomique réalisée par spectroscopie RMN du proton a montré que le régime sans polyamines permettait de réguler la neurotransmission excitatrice (glutamate) au niveau de la corne dorsale de la moelle épinière des animaux, expliquant ainsi son effet antalgique. Dans un deuxième temps, nous nous sommes intéressés aux mécanismes supraspinaux impliqués dans la neuropathie chronique induite par l’oxaliplatine, à l’aide d’une approche métabolomique par 1 H-RMN HRMAS. Cette étude a révélé d’importantes modifications métaboliques cérébrales chez les animaux traités par oxaliplatine, notamment une augmentation de la choline dans le cortex insulaire postérieur corrélée de manière significative aux seuils douloureux. Une analyse transcriptomique et pharmacologique a permis de mettre en évidence une implication de la neurotransmission cholinergique dans cette structure. Le ciblage pharmacologique de cette neurotransmission pourrait représenter une stratégie potentiellement intéressante pour le développement de nouveaux traitements antalgiques. L’ensemble de ces résultats expérimentaux a permis l’identification de nouvelles pistes pour la compréhension et le traitement des douleurs neuropathiques chimio-induites. Dans une perspective de recherche translationnelle, ces deux approches précliniques sont en cours de transposition dans des protocoles de recherche clinique. Un essai clinique de phase II (NEUROXAPOL, NCT01775449) a débuté afin de confirmer l’intérêt d’un régime appauvri en polyamines chez des patients recevant une chimiothérapie à base d’oxaliplatine. Une seconde étude clinique (INSULOX) est actuellement en cours de préparation au CHU de Clermont-Ferrand afin de mesurer par IRM les concentrations en choline dans l’insula de patients souffrant de douleurs neuropathiques induites par oxaliplatine. / Oxaliplatin, an anticancer drug used for the treatment of colorectal cancer, is responsible for a dose-limiting peripheral neurotoxicity in the majority of treated patients. This neurotoxicity appears with two components: a rapid-onset acute neurotoxicity manifesting as transient paresthesias and cold-induced dysesthesias; and a late-onset cumulative neurotoxicity characterized by the development of a painful chronic neuropathy. To date, the management of chemotherapy- induced neuropathic pain is still challenging because of the lack of effective treatments. In this context, a better understanding of the pathophysiological mechanisms underlying this neurotoxicity could lead to the identification of new therapeutic targets. Firstly, we aimed to assess the preventive effect of a polyamine deficient diet on the development of oxaliplatin-induced acute neurotoxicity. Exogenous polyamines, by positively modulating spinal NR2B-containing NMDA receptors, could facilitate pain sensitization. This study has shown that a polyamine deficient diet for 7 days totally prevented oxaliplatin-induced acute cold and mechanical hypersensitivity in rats. Although we observed no change in spinal NR2B expression or phosphorylation, intrathecal ifenprodil (a specific NR2B antagonist) reduced oxaliplatin-induced allodynia in a dose-dependent manner. Finally, proton NMR spectroscopy- based metabolomic analysis has revealed a regulation of spinal glutamate neurotransmission as the most likely mechanism underlying the preventive effect of the diet. Secondly, the metabolic variations associated with oxaliplatin-induced chronic neuropathy were assessed at the supraspinal level using a 1 H-NMR HRMAS-based metabolomic approach. Among the neurochemical changes evidenced in this study, we observed a significant increase in choline within the posterior insular cortex, significantly correlated with the mechanical pain thresholds. A transcriptomic and pharmacological approach have revealed an implication of cholinergic neurotransmission in this brain area. Targeting the cholinergic system using centrally active muscarinic agents could represent an interesting strategy for the treatment of oxaliplatin- induced neuropathic pain. These experimental results led to the identification of new molecular targets for the comprehension and the treatment of chemotherapy-associated painful neuropathy. In a translational approach, these preclinical data will be extended to the clinical setting. A phase II clinical trial (NEUROXAPOL, NCT01775449) is undergoing to confirm the therapeutic interest of a polyamine free diet in patients receiving oxaliplatin. A second clinical project (INSULOX) aiming at assessing the choline concentrations in the insula of patients suffering from oxaliplatin-induced neuropathy is in preparation.

abstract: Although models for describing longitudinal data have become increasingly sophisticated, the criticism of even foundational growth curve models remains challenging. The challenge arises from the need to disentangle data-model misfit at multiple and interrelated levels of analysis. Using posterior predictive model checking (PPMC)—a popular Bayesian framework for model criticism—the performance of several discrepancy functions was investigated in a Monte Carlo simulation study. The discrepancy functions of interest included two types of conditional concordance correlation (CCC) functions, two types of R2 functions, two types of standardized generalized dimensionality discrepancy (SGDDM) functions, the likelihood ratio (LR), and the likelihood ratio difference test (LRT). Key outcomes included effect sizes of the design factors on the realized values of discrepancy functions, distributions of posterior predictive p-values (PPP-values), and the proportion of extreme PPP-values. In terms of the realized values, the behavior of the CCC and R2 functions were generally consistent with prior research. However, as diagnostics, these functions were extremely conservative even when some aspect of the data was unaccounted for. In contrast, the conditional SGDDM (SGDDMC), LR, and LRT were generally sensitive to the underspecifications investigated in this work on all outcomes considered. Although the proportions of extreme PPP-values for these functions tended to increase in null situations for non-normal data, this behavior may have reflected the true misfit that resulted from the specification of normal prior distributions. Importantly, the LR and the SGDDMC to a greater extent exhibited some potential for untangling the sources of data-model misfit. Owing to connections of growth curve models to the more fundamental frameworks of multilevel modeling, structural equation models with a mean structure, and Bayesian hierarchical models, the results of the current work may have broader implications that warrant further research. / Dissertation/Thesis / Doctoral Dissertation Educational Psychology 2015

Introdução: a ausência de extensão completa do joelho é uma condição limitante que algumas vezes precisa ser tratada invasivamente através da realização da capsulotomia posterior do joelho, uma vez que medidas conservadoras tenham sido esgotadas previamente. No entanto, mesmo com a literatura vigente, ainda não está claro se o procedimento para aquisição de extensão do membro inferior está associado á melhora funcional de pacientes com contratura em flexão do joelho e queixas de dor anterior, bem como se este ganho de extensão pode ser mantido ao longo do tempo. Métodos: nós conduzimos um estudo de coorte retrospectivo de 21 pacientes com contratura em flexão mínima do joelho os quais foram submetidos à capsulotomia posterior do joelho por técnica aberta entre 1990 e 2010. Após 9.19 ± 6.68 anos de follow-up, os níveis funcionais do joelho e média de ângulo de contratura em flexão foram comparados com os dados pré-operatórios e a taxa de recorrência pôde ser estimada. Complicações investigadas incluíram instabilidade do joelho secundária ao procedimento e danos neurovasculares. Resultados: pré-operatoriamente, todos os pacientes (100%) apresentavam scores funcionais de Lysholm classificados como regular ou ruim (média absoluta do score 58.66 ± 13.87, 95%CI 52.35–64.98), e 15 pacientes (72%) apresentaram melhora funcional, com scores bom ou excelente (média de score de Lysholm 87.61 ± 8.81, 95%CI 83.60–91.63) após o período de follow-up. A média pré-operatória do ângulo de flexão do joelho foi de 25.04 ± 9.15 graus (95%CI 20.88–29.21) e diminuiu para 4.28 ± 4.18 graus (95CI% 2.38 – 6.19). Nenhum paciente apresentou complicações relacionadas ao procedimento Conclusão: baseado em nossos resultados, nós concluímos que a capsulotomia posterior do joelho parece ser um procedimento seguro e efetivo para tratar adequadamente pacientes com joelhos dolorosos secundários a contraturas em flexão, com uma baixa taxa de recorrência mesmo após 9.19 anos em média de seguimento. / Background: lack of full extension of the knee is a disabling condition that sometimes needs to be treated invasively by a posterior capsulotomy of the knee, since conservative treatments have been exhaustively attempted. However, it is not clear if the procedure is able to improve anterior symptoms on the knee of patients with flexion contracture and if the full extension acquired can be kept throughout long-time follow-up. Methods: we conducted a retrospective cohort study of 21 patients diagnosed with minimal flexion contracture of the knee who underwent open posterior capsulotomy between 1990 and 2010. After 9.19 ± 6.68 years of follow-up, knee function and mean angle of fixed knee flexion were compared to baseline data and the recurrence rate was estimated. Complications investigated included knee instability and neurovascular damages. Results: all patients (100%) presented with a preoperative Lysholm score classified as poor or fair (mean, 58.66 ± 13.87, 95%CI 52.35–64.98), but 15 patients (72%) experienced an improvement to good or excellent scores (mean, 87.61 ± 8.81, 95%CI 83.60–91.63) after long-time follow-up. The mean preoperative angle of fixed flexion was 25.04 ± 9.15 degrees (95%CI 20.88–29.21) and it decreased to 4.28 ± 4.18 degrees (95CI% 2.38 – 6.19, after the follow-up. Conclusion: Based on these results, we conclude that posterior capsulotomy of the knee proved to be a safe and effective procedure to treat properly patients with painful knees secondary to lack of full extension with a low rate of recurrence even after a long-term follow-up.

Introdução: A partir de relatos casos de opacifiação da lente intraocular acrílica hidrofílica Ioflex (Mediphacos, Belo Horizonte, Brasil), muitas vezes utilizada em mutirões de catarata para pessoas carentes, avaliamos a frequência das complicações oculares relacionadas com o implante desta lente quatro anos após a cirurgia, bem como seus efeitos a longo prazo na eficiência da cirurgia de catarata. Métodos: Foi selecionada amostra aleatória com 102 indivíduos submetidos à cirurgia de catarata com implante da lente intraocular Ioflex, em campanha comunitária no interior de Pernambuco, Brasil, quatro anos após a cirurgia. Um total de 31 pacientes não foi localizado e treze (18,3%) não compareceram para o exame. Assim, 58 pacientes (87 olhos) foram examinados. Para o cálculo da frequência da opacificação da cápsula posterior e para a avaliação da eficiência da cirurgia da catarata, foi selecionado apenas um olho de cada paciente. Os sujeitos foram submetidos a exame oftalmológico completo. Pacientes com redução da acuidade visual decorrentes das complicações pós-operatórias foram encaminhados para tratamento. O custo desses eventuais tratamentos foi estimado para análise da eficiência da cirurgia de catarata com a lente Ioflex. Para avaliação dos índices de opacificação da cápsula posterior as variáveis foram expressas por média e desvio padrão. Foi usado o teste t de Student\'s para análise de diferenças entre amostras independentes e pareadas. Resultados: Seis olhos (7%) apresentaram opacificação da lente intraocular. Nenhuma doença ou fator ambiental foi relacionado à opacificação da lente. A opacificação da cápsula posterior foi detectada em 39 (67%) olhos, sendo 24 (41,3%) olhos submetidos ao tratamento com laser para recuperação da acuidade visual. O custo total do tratamento das complicações pós-operatórias representou 6,3% do orçamento cirúrgico inicial. O custo adicional foi de $9,03 dólares por paciente para manter a boa acuidade visual. Conclusão: A lente intraocular acrílica hidrofílica Ioflex apresentou elevada frequência de complicações pós-operatórias tardias relacionadas à própria lente, reduzindo, a longo prazo, a eficácia e eficiência da cirurgia de catarata / Introduction: Based on reports of Ioflex hydrophilic acrylic intraocular lens opacification (Mediphacos, Belo Horizonte, Brazil), used in cataract surgeries for underserved communities, we evaluated the ocular complications related to the intraocular lens implant, four years after surgery, as well as its effects on the visual efficiency of long-term cataract surgery. Methods: A random sample of 102 patients that underwent cataract surgery and Ioflex intraocular lens implantation, in a community campaign in the rural area from Pernambuco, Brazil, four years after surgery. A total of 31 patients could not be located and 13 (18.3%) were not present for examination. Thus, 58 patients (87 eyes) were available for examination. In order to calculate the frequency of posterior capsule opacification and to evaluate the efficiency of cataract surgery, only one eye was selected from each patient. The subjects underwent a complete ophthalmological examination. Patients with reduced visual acuity due to postoperative complications were referred for treatment. The costs of these treatments were estimated for the analysis of the efficiency of the cataract surgery with the Ioflex lens in the long term period. For the evaluation of posterior capsule opacification rates the variables were expressed by means and standard deviation. The Student\'s t test was used for analysis the differences between independent and paired samples. Results: Six eyes (7.0%) had intraocular lens opacification. No disease or environmental factor could be related to intraocular lens opacification. Posterior capsule opacification was detected in 39 (67%) eyes, and 24 (41.3%) eyes were submitted to laser treatment for visual acuity recovered. The total cost of postoperative complications treatment represented 6.3% from the initial budget of the whole patients group evaluated. The additional costs to maintain a good visual outcome was USD $9.03 per patient with Ioflex lens implantation. Conclusion: The Ioflex hydrophilic acrylic intraocular lens had high rates of postoperative complications related to the intraocular lens itself, decreasing effectiveness efficiency in long-term cataract surgery

Submitted by Renata Lopes (renatasil82@gmail.com) on 2017-07-12T15:05:40Z No. of bitstreams: 1 liviamachadolimamakris.pdf: 2232519 bytes, checksum: 30831ce68bfa40c9fa6295446a8ac825 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2017-08-08T15:48:18Z (GMT) No. of bitstreams: 1 liviamachadolimamakris.pdf: 2232519 bytes, checksum: 30831ce68bfa40c9fa6295446a8ac825 (MD5) / Made available in DSpace on 2017-08-08T15:48:18Z (GMT). No. of bitstreams: 1 liviamachadolimamakris.pdf: 2232519 bytes, checksum: 30831ce68bfa40c9fa6295446a8ac825 (MD5) Previous issue date: 2017-05-24 / A sinusite maxilar de origem odontogênica é encontrada em cerca de 10% a 12% dos casos de sinusite maxilar. Algumas raízes de dentes posteriores superiores podem estar muito próximas ou invaginadas para o interior do seio maxilar. Nestes casos podem facilitar o desenvolvimento ou perpetuação da sinusite crônica, quando associadas a problemas dentais. Assim, deve-se sempre considerar a relação anatômica do seio maxilar com as raízes dentárias no diagnóstico das alterações pulpares e periapicais, no tratamento endodôntico e procedimentos cirúrgicos. O objetivo deste trabalho foi avaliar, a partir de imagens de tomografia computadorizada de feixe cônico, a relação de proximidade entre os ápices radiculares de dentes superiores posteriores (segundo pré-molar, primeiro molar e segundo molar) com as corticais do seio maxilar e as corticais ósseas vestibular ou palatina. Para isso, serão determinadas as distâncias entre os ápices radiculares e as corticais mais próximas. As mensurações foram realizadas a partir de cortes axial e coronal no software i-CAT® Vision, e após, foram classificadas em três grupos, G1 – ápice radicular dentro do seio maxilar, G2 – ápice radicular até 1 mm da cortical do seio maxilar, G3 – ápice radicular com mais de 1 mm da cortical do seio maxilar. Observou-se que com o aumento da idade há uma maior proximidade dos dentes avaliados com a cortical óssea (p< 0.05) e uma menor proximidade do 2M (p=0.005), com o seio maxilar. 207 molares (45,8%) apresentaram pelo menos uma das raízes dentro do SM. No grupo 2, não houve diferença entre os dentes avaliados. No grupo 3, os 2PM apresentaram-se mais frequentes (72%) que os 1M e 2M. Com o aumento da idade, existe uma maior proximidade dos dentes com a cortical óssea e uma menor proximidade com o seio maxilar. A raiz mésio-vestibular do 2M superior é a raiz mais próxima da cortical sinusal, enquanto o 1M superior é o dente mais próximo da cortical óssea alveolar. / The odontogenic maxillary sinusitis is found in about 5% to 10% of cases of maxillary sinusitis. Some roots of upper posterior teeth may be too close together or invaginated into the maxillary sinus. In these cases can facilitate the development and perpetuation of chronic sinusitis, when associated with dental problems. Like this, one should always consider the anatomical relationship of the maxillary sinus with the dental roots in the diagnosis of pulp and periapical changes in endodontic treatment and surgical procedures. The objective of this study is to evaluate, from images obtained through computed tomography cone-beam, the close relationship between the root tips of upper posterior teeth, second premolar, first molar and second molar, with the sinus cortical jaw, buccal and palatal. For this, the distances between the root apexes and the cortical ones will be determined. The roots will be distributed into three groups. The measurements will be held from axial and coronal sections in i-CAT® Vision software, and will be classified into four three, G1- root apex in maxillary sinus, G2- apex até1mm the cortical bone of the maxillary sinus, G3- apex root more than 1 mm from the cortical bone of the maxillary sinus. It was observed that when increases the age, there is a greater proximity of the evaluated teeth regarding the maxillary cortical bone (p<0.05) and less proximity of 2M to MS (p=0.005). 207 molars (45.8%) had at least one of the roots within the MS. In the group G2, there was no difference between the evaluated teeth. In group G3, 2PM were more frequent (72%) than 1M and 2M. When increasing age, there is a greater proximity of the teeth to the maxillary cortical bone and a lesser proximity to the MS. The mesiobuccal root of the maxillary 2M is the closest root to the MS cortical, while the maxillary 1M is the closest tooth to the maxillary cortical bone.

Made available in DSpace on 2014-08-20T14:30:05Z (GMT). No. of bitstreams: 1 tese Rudimar_Antonio_Baldissera.pdf: 912046 bytes, checksum: 2e67255564e6053c35182672be9085fd (MD5) Previous issue date: 2012-09-14 / Composite restorations are daily performed in dental offices; however, few studies have reported the longevity of these restorations for long periods of observation. This study was conducted to evaluate the clinical performance of resin composite restorations placed in anterior and posterior teeth in the period between the years 1991 and 2001. From the files of a private dental clinic, 83 patients who received 375 restorations in posterior teeth and 61 patients with 237 restorations in anterior teeth with the composites Charisma (Heraeus Kulzer, Hanau, Germany), Herculite XR (Kerr, Orange, CA, USA) or Z100 (3M ESPE, St. Paul, MN, USA) participated in the study, being examined by two calibrated researchers. The restorations were evaluated according to the FDI criteria (World Dental Federation, HICKEL et al., 2007). After the fieldwork, data were double tabulated and subjected to statistical analysis using Stata version 11.0. Descriptive statistics were used to report the frequency of distribution of the restorations for the variables evaluated and for the causes of failures. The survival analyzes were performed using the Kaplan-Meier method, to obtain the survival curves for the variables of interest, followed by the Log-Rank test for comparison between groups (α=0.05). The analysis of factors associated with failure over time was performed using a model of multivariate analysis by Cox regression with shared fragility. Of the total of 612 restorations, 69 were considered unsatisfactory. The annual failure rate observed at the final of the period was 0.76 to anterior teeth and 1.16 to posterior teeth. The aesthetic factor was the major cause in the anterior teeth, while in posterior were the fractures. Regarding the material, the composite Herculite was significantly better than Z100 and this better than Charisma. Restorations with the largest number of surfaces involved had the worst performance. The result of this study showed a satisfactory clinical performance. In relation of the material, the composite Herculite was significantly better than the Z100 and this better than Charisma. The restorations with the highest number of surfaces involved had the worst performance / Restaurações de resina composta são confeccionadas diariamente nos consultórios odontológicos, porém poucos estudos reportam a longevidade destas restaurações por longos períodos de observação. Este estudo foi realizado para avaliar o desempenho clínico de restaurações de resina composta inseridas em dentes anteriores e posteriores no período de 1991 a 2001. A partir da verificação de prontuários do arquivo de uma clínica odontológica privada, 83 pacientes que receberam 375 restaurações em dentes posteriores e 61 pacientes com 237 restaurações em dentes anteriores com os compósitos Charisma (Heraeus Kulzer, Hanau, Alemanha), Herculite XR (Kerr, Orange, CA, EUA) ou Z100 (3M ESPE, St. Paul, MN, EUA) participaram do estudo e foram examinados por dois pesquisadores calibrados. As restaurações foram avaliadas de acordo com os critérios de avaliação clínica de restaurações propostos pela FDI (Federação Dentária Internacional) . Após o trabalho de campo, os dados foram tabulados por 2 digitalizadores e submetidos à análise estatística usando o Stata versão 11.0. Estatística descritiva foi usada para reportar a frequência de distribuição de restaurações para as variáveis avaliadas e para as causas de falhas. As análises de sobrevida foram realizadas pelo método de Kaplan Meier, para a obtenção das curvas de sobrevida para as variáveis de interesse, seguido do teste Log-Rank, para comparação entre grupos (α=0,05). A análise de fatores associados a falha ao longo do tempo foi realizada através de modelo de análise multivariável por regressão de Cox com fragilidade compartilhada. Do total das 612 restaurações, 69 foram consideradas insatisfatórias. A taxa de falha anual observada no final, foi de 0,76 para os dentes anteriores e de 1,16 para os posteriores. O fator estético foi a principal causa nos dentes anteriores enquanto que nos posteriores as fraturas., Em relação ao material a resina Herculite mostrou-se significantemente melhor que a Z100 e esta melhor que a Charisma. As restaurações com o maior número de faces envolvidas tiveram o pior desempenho. O resultado deste estudo mostrou que os compósitos apresentaram um bom desempenho clínico tanto em dentes posteriores quanto em anteriores, no acompanhamento a longo prazo