Doutorado em Odontologia (FO)
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Item Desempenho biomecânico de novos retentores intrarradiculares em dentes com ou sem férula(Universidade Federal de Goiás, 2020-02-28) Almeida, Letícia Nunes de; Fonseca, Rodrigo Borges; http://lattes.cnpq.br/8629552867290605; Fonseca, Rodrigo Borges; Lopes, Lawrence Gonzaga; Barata, Terezinha de Jesus Esteves; Kasuya, Amanda Vessoni Barbosa; Favarão, Isabella NegroThe aim of this study was to evaluate the influence of intrarradicular post system and the amount of coronary remnant (ferrule) on maximal fracture load, fracture pattern and stress distribution of endodontically treated teeth. Eight experimental groups were created: Pf-0 e Pf-2 - glass fiber post (GFP) no. 3 in teeth with and without ferrule respectively; GFP no. 1 relined with experimental composite (EC) with and without ferrule respectively; EC-0 and EC-2 - custom post made with the experimental composite (EC) with and without ferrule respectively, CAD-0 e CAD-2 - custom milled post with and without ferrule respectively. The EC was composed of 22.5 wt% of methacrylate resin (Bis-GMA, TEGDMA, Bis-EMA), 30% of glass fibers and 47.5% of filler particles. After endodontic treatment, post cementation and crowns with composite resin, the teeth were tested to verify the maximum fracture load (n = 10) in a universal testing machine (Instron 5965) a 0.5 mm/min. Subsequently, the fracture pattern was analyzed and stress distribution was evaluated by the finite element method using the modified von Mises criterion (MSC Marc & Mentat). The maximum fracture load results were subjected to factor analysis, and subsequently Kolmogorov-Smirnov, ANOVA, Tukey and T-Test for comparison between groups (α = 0.05). Interaction was observed between the factors under study (p = 0.046), and ANOVA and Tukey showed a statistically significant difference between the groups (p = 0.001). EC-0 (752.81N) and CAD-0 (728.84N) were similar and superior Pr-0 (545.16) and Pf-0 (498.01N). In ferrule groups, all retainers were similar (p>0.05) Pf-2 (791.85), Pr-2 (699.1), EC-2 (822,81), CAD-2 (779.89). Pf-0 showed a greater number of non-repairable failures and the Pr-2 posts promoted a greater number of favorable failures. Groups without ferrule showed higher number of non-repairable failures. The posts made with EC showed lower stress concentration and the posts made by CAD / CAM technique, the highest stress concentration. Retainer type and presence of ferrule influence on maximal load, fracture pattern and stress distribution of endodontically treated teeth. CE custom posts promote higher maximum fracture load and more favorable stress distribution.Item Acurácia de três tomógrafos e dois softwares no diagnóstico de defeitos peri-implantares do tipo deiscência: estudo in vitro(Universidade Federal de Goiás, 2022-03-04) Ferreira, Mário Serra; Silva, Maria Alves Garcia Santos; http://lattes.cnpq.br/9660554027842420; Silva, Maria Alves Garcia Santos; Roriz, Virgílio Moreira; Rabelo, Luiz Eduardo Gregoris; Sousa, Thiago Oliveira; Gasperini, GiovanniIn evaluating of the peri-implantitis, Cone Beam Computed Tomography (CBCT) has the advantage of estimating the bone site in a three-dimensional manner; however, the production of artifacts represents a negative factor against high-density materials. The objective of this work was to evaluate the accuracy of three CT scanners and two software in the identification and measurement of peri-implant dehiscence defects in vitro. For this, 36 bovine rib models were prepared to receive a Morse taper titanium implant Torq® 13 X 4,0 mm (Conexão, Arujá, São Paulo, Brazil). The ribs were divided into three groups: a group without bone defect as a control (n=12), a group with a dehiscence-like defect from 1.0 mm to 2.5 mm (n=12), and a group with a dehiscence-like defect > 2.5 to 4.15 mm (n=12). Rib blocks were submitted to CBCT using three different devices: Carestream 8100 3D (Carestream Health, Rochester, New York, USA), PreXion 3D (PreXion Inc, San Mateo, California, USA), and Orthopantomogram OP300 (Instrumentarium Kavo Kerr, Tuusula, Finland). These images were imported and processed by two software programs: e-Vol DX (CDT Software, Bauru, São Paulo, Brazil) and InVivo (Anatomage, San Jose, California, USA). Two evaluators experienced in identifying bone defects in tomographic images analyzed the presence/absence of a peri-implantitis dehiscence type defect and independently measured the size of the defect using a linear measurement tool using a five-point scale and measured the defect using a linear measurement tool. ROC curve was created to evaluate the accuracy, and the Friedman test was used to analyze the variables between the e-Vol DX and InVivo software. The results demonstrated a 100% accuracy value for defect detection with PreXion and Carestream and 98% for the OP300 across all defect sizes. The area under the curve presented 100% accuracy for InVivo and 99% for the e-Vol DX. Regarding measurement, the software showed a statistically significant difference, following the mean values: reference standard (2.6111), e-Vol DX (1.8542), and InVivo (1.5347). All equipment and software tested showed good accuracy in detecting dehiscence. In the measurement of defects, the e-Vol DX showed better results than the InVivo, but both software underestimated the real measurements.Item Avaliação de cimentos e técnicas de obturação no preenchimento de istmos radiculares usando um novo software de tomografia computadorizada de feixe cônico(Universidade Federal de Goiás, 2022-05-25) Morais, André Luiz Gomide de; Estrela, Carlos; http://lattes.cnpq.br/3611967334176683; Oliveira, Helder Fernandes de; Siqueira, Patrícia Correia de; Silva, Júlio Almeida; Silva, Brunno Santos de Freitas; Estrela, CarlosAim: To evaluate the sealing ability of root isthmuses using different sealers and root canal filling techniques using a new Cone Beam Computed Tomography software (e-Vol DX). Methodology: 120 lower molars extracted from patients with indication for extraction were used. The teeth were divided into 6 groups according to the endodontic sealer and filling technique: G1: AH Plus® + lateral condensation technique (n=20), G2: AH Plus® + Tagger's hybrid technique (n=20), G3: AH Plus® + single cone technique (n=20), G4: BioRoot RCS + lateral condensation technique (n=20), G5: BioRoot RCS® + Tagger hybrid technique (n=20) and G7: BioRoot RCS® + single cone technique (n=20). The teeth were instrumented using the Wave One Gold® reciprocating system, irrigation performed with 2.5% sodium hypochlorite and EDTA (using ultrasonic passive irrigation) and then all canals were filled according to the division of the groups. Sealing evaluation was performed using scores. Nonparametric statistics were used for its analysis and the description was performed by median, minimum and maximum. Mann Whitney test was used to compare the scores between the sealers and Kruskal-Wallis test followed by Dunn-Bonferroni post hoc tests between the obturation techniques and groups. To compare scores obtained with and without Blooming Artifact Reduction (BAR) filter of e-Vol DX software, Wilcoxon test was used. Results: Results showed there was a significant difference in sealing lower molar isthmus using endodontic sealers studied in apical third with BAR (p=0.016), with scores being higher for AH Plus®. There were differences in sealing of lower molar isthmus using different filling techniques in middle and apical thirds. For middle third without BAR, difference was between single cone and Tagger's hybrid techniques (p=0.011) as well as for apical third without BAR (p<0.001). For middle third with BAR, difference was between single cone technique and lateral condensation (p=0.043) and Tagger hybrid (p=0.009) techniques. For apical third with BAR, the difference was between Tagger's hybrid technique and single cone (p<0.001) and lateral condensation (p=0.041) techniques. When comparing the sealing scores using different filling techniques and types of sealer, there were differences between G2 and G3 (p=0.015) and G2 and G6 (p=0.024) in apical third without BAR. Using BAR tool, statistical differences were as follows: in cervical third between G2 and G6 (p=0.023); in middle third, between G2 and G6 (p=0.072); in apical third, G6 had lower scores than G1 (p=0.046), G2 (p=0.002) and G5 (p=0.011) and G4 had lower scores than G2 (p=0.023). When comparing isthmus sealing scores with and without using BAR tool, there were significant differences, with higher values without using the tool, in all thirds. It is concluded that, when evaluating sealing ability of root isthmus using different sealers and filling techniques with e-Vol DX software, the best combination was the use of AH Plus and Tagger's hybrid technique. Using BAR filter of the eVol DX software in CBCT images showed more empty spaces in filling mass due to the reduction of white expansion, making tomographic image more reliable.Item Avaliação imunoistoquímica de mediadores envolvidos na evasão imunológica de células tumorais em carcinoma adenóide cístico de glândulas salivares(Universidade Federal de Goiás, 2020-10-15) Mosconi, Carla; Mendonça, Elismauro Francisco de; http://lattes.cnpq.br/2305019128015847; Mendonça, Elismauro Francisco de; Silva, Tarcília Aparecida; Mesquita, Ricardo Alves de; Alves, Pollianna Muniz; Costa, Nádia do LagoJustificativa do estudo: O Carcinoma adenoide cístico (CAC) é um dos tumores de glândulas salivares mais comuns na região de cabeça e pescoço. Caracteriza-se por possuir evolução lenta, curso clínico prolongado, ser altamente infiltrativo, com altas taxas de recidivas, ocorrência de metástase regional e à distância. Para evitar a ocorrência de metástases, as células neoplásicas devem ser combatidas pelo sitema imunológico. Os mediadores que estão expressos em células neoplásicas e linfócitos, podem propiciar a imunossupressão e o escape das células tumorais favorecendo a ocorrência de metástase local e a distância. Objetivos: O objetivo deste estudo foi avaliar a expressão das proteínas HLA-G, PD-L1, PD-L2, CD8, GrB, CD1a, CD83, CTLA-4 e PD- 1 em amostras de CAC e a associação destas com os parâmetros clinicopatológicos da doença. Material e métodos: Foram selecionadas 36 amostras de CAC e a identificação da expressão das proteínas foi realizada pela técnica da imunoistoquímica. As células neoplásicas do CAC, positivas para as proteínas HLA-G, PD-L1, PD-L2, foram avaliadas semi-quantitativamente em porcentagem de células positivas (0 – 100%) e do infiltrado inflamatório positivas para CD8, GB, CD1a, CD83, CTLA-4 e PD-1 foram quantificadas e convertidas em densidade (células/mm2). Amostras de trofoblastos, líquens plano e linfonodos foram utilizados como controle positivos das reações. Resultados: O CAC apresentou baixa expressão de TIL CD8+, GrB+, CD1a+ e CD83+, assim como, escassa positividade para CTLA-4 e PD-1. De forma contrária, observou-se expressão de PD-L2 e HLA-G, enquanto PD-L1 foi negativo em todas as amostras avaliadas. Interessantemente, casos que tinham baixa densidade de TIL CD8+, apresentaram maiores taxas de recidivas. Conclusão: Nossos achados sugerem que o microambiente do CAC apresenta uma baixa imunogenicidade, representada pela baixa densidade de TIL e células dendríticas. Além disso, parece haver ativação das proteínas inibitórias imunes PD-L2 e HLA-G, o que sugere um cenário que pode favorecer o escape tumoral do sistema imunológico e contribui para o prognóstico desfavorável dessas neoplasias.Item Ambiente escolar promotor de saúde, qualidade educacional e saúde bucal de adolescentes das capitais brasileiras: estudo com base na Pesquisa Nacional de Saúde do Escolar (PeNSE 2015)(Universidade Federal de Goiás, 2020-02-20) Nery, Newillames Gonçalves; Jordão, Lidia Moraes Ribeiro; http://lattes.cnpq.br/8872679253627903; Freire, Maria do Carmo Matias; http://lattes.cnpq.br/6056344372250078; Freire, Maria do Carmo Matias; Costa, Luciane Ribeiro de Rezende Sucasas da; Novais, Tatiana Oliveira; Weiss, Veruska Prado Alexandre; Faria, Patrícia Corrêa deEvidence about the influence of contextual factors of schools and municipalities on the oral health of adolescents is scarce, with important gaps in relation to the school environment. The aim of this study was to investigate associations between the potential support of schools for oral health promotion, the educational quality of the school and oral health outcomes among adolescents in the Brazilian State Capitals. The study was cross-sectional, with individual and aggregated approaches. Data were obtained from the Brazilian National Adolescent School-Based Health Survey (PeNSE) and the Basic Education Development Index (IDEB), conducted in 2015, in addition to other secondary sources. The individual variables referred to students in the 9th grade of elementary schools: sociodemographic, prevalence of dental pain and oral health-related behaviours (frequencies of dental visits, toothbrushing, and soft drinks and sweets consumption, cigarette and alcoholic beverages experimentation). The contextual variables were related to schools, Brazilian capitals and regions (educational quality of the school – measured by IDEB, Human Development Index - HDI and Gini Index). The analyses were carried out in three steps. In step 1, the Oral Health Promoting School Environment (OHPSE) indicator was obtained using the Categorical Principal Components Analysis (CATPCA), to measure the potential support of school environment for oral health promotion in public and private schools of the capitals. Bivariate associations (Chi-square test) between OHPSE and contextual variables were verified. In step 2, associations between OHPSE (explanatory variable) and dental pain and oral health-related behaviours (outcome variables) were tested in two-level multi-level mixed-effects Poisson regression. And in step 3, with data aggregated by capitals, associations were verified between IDEB and the outcomes: the OHPSE indicator and its dimensions (in public schools), dental pain and oral health-related risk behaviours. In all steps, the level of significance was 5%. The results were: Step 1 - There was a higher frequency of schools with higher OHPSE in the public schools (58.1%), and in regions and capitals with a lower Gini Index (52.8% / 55.7%) and higher HDI (57.4% / 61.0%), respectively. Step 2 - In the adjusted model, private and public schools with higher OHPSE had 6%, 6% and 4% lower prevalence rates of a “low frequency of annual dental visits” [PR = 0.94 (95%CI 0.90; 0.99)], “high weekly soft drinks consumption” [PR = 0.94 (95%CI 0.89; 0.99)] and “high weekly sweets consumption” [PR = 0.96 (95%CI 0.93; 1.00)], respectively. Schools with intermediate OHPSE had 12% and 8% higher prevalence ratios of a “low daily toothbrushing frequency” [PR = 1.12 (95%CI 1.03; 1.23)] and “cigarette experimentation” [PR = 1.08 (95%CI 1.01; 1.16)]. OHPSE was not associated with dental pain and "alcoholic beverages experimentation". Step 3: IDEB correlated with the OHPSE dimension referred to within-school aspects, with “low daily toothbrushing frequency” and with “low frequency of annual dental visits”. In the adjusted regression model, capitals with the higher IDEB were associated with “low daily toothbrushing frequency” [B = 1.560 (95% CI 0.360; 2.760), p = 0.013; β = 0.519]. It was concluded that were associations between the potential support of school environment for oral health promotion and some oral health outcomes of adolescents in the Brazilian capitals. Higher potentials for oral health promotion (in private and public schools) were related to more favorable behaviours regarding dental visits and consumption of food with added sugars, and less favorable for toothbrushing frequency and cigarette experimentation, while better educational quality (in public schools) was related to low toothbrushing frequency among adolescents. Inequalities among schools regarding oral health promotion were also found, indicating the need to reorient public policies for the oral health of schoolchildren.Item Motivação de adolescentes para começar e parar de fumar e fatores associados: estudos embasados em teorias de mudança de comportamento(Universidade Federal de Goiás, 2020-12-22) Rios, Leonardo Essado; Freire, Maria do Carmo Matias; http://lattes.cnpq.br/6056344372250078; Freire, Maria do Carmo Matias; Faria, Patrícia Corrêa de; Oliveira, Ana Cristina Borges de; Oliveira, Ana Maria de; Pinheiro, Helder Henrique CostaIntroduction: Smoking is a chronic disease caused by nicotine dependence, and a risk factor for several general and oral health problems. Multiple factors have been linked to smoking during adolescence, including psychosocial indicators. At the same time, the Behaviour Change Science has advanced in identifying the three essential elements of the mental motivational system that prompts smoking initiation and cessation: beliefs, desires, and intentions. However, the relationships between these factors need to be better understood in the adolescent population. Objective: To investigate the motivation of adolescent students to start and stop smoking based on Behaviour Change Theories and associated factors. Methods: A systematic review of the literature with meta-analysis, and three cross-sectional analytical studies were carried out. Adolescents aged 12 to 19 years were the target population. In the review, a systematic search for eligible studies was conducted on scientific bases by previously calibrated reviewers, who selected and evaluated studies about the intention of adolescents to quit smoking based on the Transtheoretical Model of Stages of Change. In the cross-sectional studies, the data were collected in federal schools of a Brazilian Midwest state. A self-administered questionnaire was used, containing: a) questions based on the Prime Theory of Motivation that measured desires, beliefs and intentions related to smoking initiation and cessation, b) psychosocial variables through validated scales of Sense of Coherence (SOC) and Duke University Religion Index (DUREL), and c) questions about adolescents' belief regarding the benefit of smoking cessation interventions in medical and dental services. Poisson or Logistics regressions were used in the statistical analysis. Results: Among the participants in the systematic review (n=6469), 41% of smokers had no intention of quitting smoking, which was associated with more unfavourable characteristics in relation to smoking, such as lower decisional balance and self-efficacy (p<0.05). In the cross-sectional analyses (n=3034), most smokers (57%) did not want to, nor intended to quit smoking, and approximately 6% of the non-smokers had the highest level of motivation to start (simultaneous presence of desire, belief, and intention). Among the non-smokers, an inverse association was observed between the motivation to start smoking and the SOC, so that for each increase of one unit in the SOC score, the probabilities of desire to smoke, belief in the benefit of the habit, and intention to smoke in the future decreased by three, three and five times, respectively. Similarly, for each unit increased in scores for Organizational, Non-Organizational, and Intrinsic Religiosity, the likelihood of motivation to start smoking decreased by 23, 23 and 15 times, respectively. Among the smokers, an increase in the Intrinsic Religiosity score increased the motivation to quit by 1.13 times. Compared to those unmotivated to quit smoking, the motivated ones had a greater belief in the benefit of interventions for smoking cessation in health services (p <0.05). Conclusion: The proportion of adolescents motivated to start or stop smoking was low and associated with psychosocial factors, which could be considered as potential influences of anti-smoking interventions for this population.Item Harmonização orofacial: Análise do conhecimento dos cirurgiões-dentistas sobre os riscos clínicos e aspectos legais e éticos na prática da rinomodelação e bichectomia(Universidade Federal de Goiás, 2021-02-23) Rodrigues, Lívia Graziele; Silva, Rhonan Ferreira; http://lattes.cnpq.br/4551378145791273; Silva, Rhonan Ferreira; Dias, Paulo Eduardo Miamoto; Rosário Júnior, Ademir Franco do; Costa, Nádia do Lago; Goulart, Douglas RangelDentistry has proved to be a complex science that treats the patient holistically, restoring the masticatory functions and the aesthetics expected for a natural smile. However, when permeating the field of facial aesthetics, many dentist have been carrying out various procedures, which are considered controversial according to dental practice. Orofacial harmonization consists of making of a patient's face more aesthetically proportional through procedures such as: facial filling with biomaterials, application of botulinum toxin, bichectomy, cervical lipoplasty and rhinomodeling. The objective of this study is to evaluate the perception of dentists regarding the technical capacity to perform rhinomodeling and bichectomy procedures regarding the legal support for their performance. After approval by the ethics committee, a self-administered structured questionnaire with 16 questions about the participant's profile, orofacial harmonization topics and specific subjects on bichectomy and rhinomodeling was applied to the professionals who were willing to participate. Of the 180 questionnaires answered, 105 (58.3%) were from female professionals, 41 (22.9%) said they performed orofacial harmonization procedures in their clinical routine. Asked about feeling able to treat an already installed nasal necrosis, 19 (11.0%) participants declared to be qualified to proceed with this type of treatment, while 110 (72.8%) of them informed that they would forward this case of complication to a Doctor. It was possible to perceive that, in general, the professionals are not aware of the norms that support them regarding the performance of new procedures included in the list that Dentistry already practices, in addition, even among the professionals who attended training courses in Orofacial Harmonization, most of them do not feel prepared to perform procedures such as rhinomodeling and treat complications resulting from bichectomy surgery.Item Otimização dos protocolos de aquisição de tomografia computadorizada por feixe cônico para redução da dose de radiação(Universidade Federal de Goiás, 2022-02-23) Santos, Ananda Amaral; Silva, Maria Alves Garcia Santos; http://lattes.cnpq.br/8760691456576488; Silva, Fernanda Paula Yamamoto; http://lattes.cnpq.br/0511229119340734; Silva, Brunno Santos de Freitas; Mosconi, Carla; Silva, Fernanda Paula Yamamoto; Arruda, Karine Evangelista Martins; Paiva, Rogério Ribeiro deCBCT is influenced by a series of variables such as: the equipment, FOV, exposure time, mA, kVp and also the spatial resolution defined by the voxel size. As the dose should be as low as diagnostically possible, it’s reduction is only possible when the image quality is maintained. It is possible to reduce the radiation dose in patients undergoing dental exams without causing harmful impact on the image quality and, therefore, on diagnostic accuracy, by changing exposure parameters in CBCT equipment, so, the optimization of protocols is sought, for each device, characterized by low radiation dose and high image quality. This study aimed to evaluate the influence of different CBCT exposure protocols in reducing the radiation dose in a CBCT equipment while maintaining image quality. For this, medullary follicles were used in thermoluminescent regions, including radiosensitive regions, including bone, bone, skin, salivary glands, brain and eyes, eyes visible in an anthropomorphic Alderson RANDO® phantom. Eight different ones were performed on the Picasso Trio® scanner (Vatech, Hwaseong, South Korea), with different variations of kVp, mA and number of base images. The effective dose was defined by the International Commission in accordance with Radiological Protection. A subjective assessment of image quality was performed by three experts. When comparing the 8 acquisition protocols, the protocol that obtained the lowest values of radiation DE was protocol 1. The protocol that obtained the highest radiation DE was protocol 8. Protocol 5 (3 mA, 99kVp, 450 IB) proves to be an ideal option among the protocols, due to the low DE associated with a good score obtained when evaluating image quality More studies are needed to standardize a methodology in order to compare different equipment.Item Análise topográfica e histológica de enxertos de mucosa ceratinizada removidos com mucótomo ou bisturi convencional: estudo ex-vivo em mandíbula suína.(Universidade Federal de Goiás, 2022-09-14) Santos, Kleber Vinícius Rodrigues dos; Leles, Cláudio Rodrigues; http://lattes.cnpq.br/6740286066154410; Leles, Cláudio Rodrigues; Leles, José Luiz Rodrigues; Roriz, Virgilio MoreiraTo evaluate the surface and tissue quality of EMC obtained by the technique with conventional scalpel and mucotome. Methods: This is an experimental in vitro/ex vivo study. Six swine hemi-mandibles that had a favorable keratinized tissue condition were used for specimen removal in the anterior region of the mandible. Specimens were obtained using mucotome and conventional scalpel. For the purpose of greater precision, the procedure for removing specimens from the jaws was performed by a specialized and previously trained dental surgeon, offering the same conditions for graft removal by both techniques. random drawing to determine the technique to be performed for tissue removal. The specimens were prepared according to the protocols pre-established by the laboratories and then they were taken for analysis in optical microscopy to evaluate the epithelium and connective tissue and in scanning electron microscopy for analysis of topography and 3D profilometry. Results: Two areas were analyzed per sample with dimensions of 1920 x 2560 μm. It was possible to notice the presence of keratinized stratified squamous epithelial tissue and dense connective tissue modeled on the tissue slides removed with mucotome and scalpel. In the tissues removed with mucotome, there is a linearity in the tissue base and in the thickness of the tissue as a whole, presence of submucosa, fibrous connective tissue that is ideal for the success of the graft Differences in the surface of the samples removed by the two techniques were observed when to compare the images obtained through the two types of microscopy. Conclusion: Keratinized mucosa grafts when removed by the mucotome technique present greater uniformity and lower presence of undesirable cells compared to the scalpel technique, favoring a greater chance of success in surgical procedures for soft tissue grafting.