Mestrado em Odontologia (FO)

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Desajuste Marginal de Infra-estruturas metálicas de próteses fixas sobre implantes considerando tipos de pilares, materiais e solda a laser
(Universidade Federal de Goiás, 2005-03-24) PEREIRA, Richard Esteves; GUILHERME, Aderico Santana; http://lattes.cnpq.br/8753467344512117
The adaptation precision of metallic structures to implant abutments is a very questionable subject and the scientific literature lacks about the alloy that shows an adaptation closer to the ideal. This study had the proposal of: evaluating the vertical marginal misfit levels (in μm) using a digital microscope of one-piece and after laser welding metallic structures of total fixed implant supported prosthesis casted in Nickel-Chrome, Nickel-Chrome-Titanium-Molibidenium and Palladium-Silver alloys and commercially pure Titanium, over two different kinds of abutments and, also, associate the misfit results observed at the one-piece structures phase with the data obtained after the laser welding treatment. After the fabrication of two master models, 40 pre-fabricated copings for both Estheticone and Micro-Unit type abutments were used at the survey. Eight metallic structures were casted with Ni-Cr, Ni-Cr-Ti-Mo, Pd-Ag and Ti-c.p., being two structures for each alloy. The vertical misfit values concerning the relation of the metallic structures and implant abutments from all alloys and on both stages one-piece and after laser welding were tabulated and then submitted to statistical tests. The values were exposed to the ANOVA and the significant statistic means were compared by the Tukey test considering a 5% significance value (p<0.05), as well as the standard deviation. The results evidenced that the one-piece structures showed misfit, but the mean values did not present statistic significant differences. The material (alloys) analysis showed that the Ti-c.p. did not show discrepant mean values, but the same did not occur with the other alloys. The comparison between all alloys showed no significant statistical differences, and, the Pd-Ag alloy (control group) showed the higher misfit mean values at the one-piece phase. The relation between the one-piece and after laser welding phases showed the presence of statistic significant values, based on the mean values (onepiece= 0.0953 μm / laser welding=0.0452 μm) and the marginal vertical misfit after laser welding appeared significantly decreased.
Uso do laser de baixa intensidade (GaAlAs) na prevenção de mucosite bucal em pacientes submetidos a transplante de medula óssea
(Universidade Federal de Goiás, 2006-01-13) SILVA, Geisa Badauy Lauria; SILVA, Maria Alves Garcia Santos; http://lattes.cnpq.br/8760691456576488
Oral mucositis is one of the most debilitating complications in patients undergoing bone marrow transplants, occurring 50 to100% in these patients. The oral mucositis treatment and prevention is not completely defined, although the low intensity laser is widely used. The aim of the current study was to investigate the use of low intensity laser (GaAlAs) in the prevention of oral mucositis induced by conditioning regimen in patients undergoing bone marrow transplants. The study was a clinical trial and a total of 42 subjects undergoing allogenic and autologus bone marrow transplant at Araujo Jorge Cancer Hospital of the Combact Cancer Association of Goiás were enrolled. All patients received a high dose chemotherapy conditioning regimen associated or not with total body radiation. The Experimental Group received the hospital protocol of oral hygiene and preventive irradiation of low level laser (660nm) on day -4 (D-4) through post-transplant day 4 (D+4). The Control Group received just the hospital protocol of oral hygiene. Oral mucositis degree was evaluated daily according to the World Health Organization Scale (WHO) on day -2 until the wound healing. The Group which low level laser treatment was performed prophylactically, 57,1% of patients were free from mucositis and no one showed mucositis degree III and IV. The difference between both Groups related to the occurrence (p<0,001) and severity (p<0,008) of oral mucositis were statistically meanful. It was concluded that the low level laser treatment, prophylactically reduces the occurrence and severity of oral mucositis
Análise microscópica e da imunoexpressão dos marcadores de proliferação celular Ki-67 e Ciclina B1 no epitélio gengival de pacientes sob terapia com nifedipina
(Universidade Federal de Goiás, 2006-02-28) Castro, Luciano Alberto de; Batista, Aline Carvalho; Mendonca, Elismauro Francisco de; http://lattes.cnpq.br/2305019128015847; Mendonça, Elismauro Francisco de; Guimarães, Maria do Carmo Machado; Guilherme, Adérico Santana
Drug induced gingival overgrowth (DIGO) is an adverse effect associated with the chronic use of three main drugs: phenytoin, an anticonvulsant, cyclosporin, an immunosuppressant drug and the pharmacological agents known as calcium channel blockers (CCB). Nifedipine is a calcium channel blocker, which because of its strong vessel dilating action has become widely used in cardiotherapy, in particular for the control of arterial hypertension. The aim of this study is to evaluate the microscopic characteristics and the epithelial proliferation index of gingival tissue in patients undergoing chronic treatment with nifedipine. To do so, twenty samples of gingival tissue of patients undergoing chronic treatment with nifedipine were obtained. The majority of these patients did not present clinically detectable gingival overgrowth. For comparative purposes, nine samples of gingival tissues of healthy patients who did not use drugs associated with gingival overgrowth (control) were used. The samples were microscopically analyzed using hematoxylin-eosin staining, to determine the size of the epithelial rete pegs. To carry out the epithelial proliferation index evaluation, a cellular identification of the Ki-67 and B1 Cyclin proteins was done using the immunohistochemical technique (streptavidin-biotin-peroxidase), as well as the quantification of positive cells (+cells) in mm².The results showed that the epithelial tissue of nifedipine users has considerably longer rete pegs that of the control group (Mann-Whitney, p=0.02). However, with regard to the proliferating activity of the keratinocytes, no significant difference was observed between the two groups (Mann-Whitney, p>0.05). The findings show that the microscopic alterations observed in the epithelium of nifedipine users are not caused by the mitotic activity of the keratinocytes but taking data from the literature into consideration, it is suggested that this increase might be caused by an inhibition of apoptosis rate of these same cells.
Percepção de desfechos relacionados à prótese dentária em indivíduos desdentados
(Universidade Federal de Goiás, 2006-05-29) Morandini, William José; Lele, Cláudio Rodrigues; http//lattes.cnpq.br/6740286066154410; Leles, Cláudio Rodrigues; Brandini, Daniela Atili; Rocha, Siknan Soares da
Self-perception of potential outcomes of prosthodontic treatment, including benefits, risks and consequences of not replacement of missing teeth, were studied in edentulous patients. Initially, using a qualitative approach, it was developed a instrument containing 41 affirmatives that comprise a scale and sub-scales that measure subject’s perception score in a 5-point Likert-type scale (1=strongly disagree; 2=disagree; 3=neutral; 4=agree; 5=strongly agree). Subsequently 126 partially or totally edentulous subjects were interviewed. Mean age was 51.8-years (SD=12.3), 74% female. Cronbach’s alfa coefficient of scale and sub-scale ranged from 0.70 and 0.90. Influence of age, gender and clinical variables were tested using analysis of variance and independent t-test. Sum of scores for each subject ranged from 123 to 198, mean score was 173.8 (SD=14.8). Subjects tended to agree with the proposed affirmatives (scores 4 and 5). Considering the total scale, lower scores were obtained by younger (p=0.033), male (p=0.019) and subjects with a single missing tooth (p=0.004). Using sub-scale of benefits, with single missing teeth subjects ranked lower scores (p=0.021). No variables showed significant relationship with perception scores using risks sub-scale. When considering sub-scale that measures perception of consequences of not replacement, lower scores were obtained by males (p=0.033), single missing tooth (p=0.018) and non wearers of prosthodontics (p=0.000). It was concluded that perception of potential outcomes of prosthodontic treatment was influenced by clinical variables. Older subjects, female, subjects with grater number of missing teeth and that have been previously treated have greater perception of benefits and risks of prosthodontic treatment.
Detecção de HPV e avaliação do índice de proliferação celular entre carcinomas espinocelulares e carcinomas verrucosos de boca
(Universidade Federal de Goiás, 2006-11-27) SPÍNDULA FILHO, José Vieira de; CRUZ, Aparecido Divino da; http://lattes.cnpq.br/7868817504129985; MENDONÇA, Elismauro Francisco de; http://lattes.cnpq.br/2305019128015847
Squamous cell carcinoma (SCC) is the most common malignant neoplasm of the bucal cavity, and one of its variants is verrucous carcinoma (VC), of low degree malignancy. The diagnosis of VC is difficult from the clinical as well as from the histopathological point of view, and an effective diagnosis is vital when deciding on the treatment and prognosis of this tumor. The aim of this research was to evaluate cell proliferation and investigate the presence of HPV in spindle cell carcinoma of the mouth so as to check for possible differences in the aetiopathogenesis and biological behavior of these lesions. Forty-seven samples were selected and divided as follows: 39 SCCs, 8 VCs and 9 control (CT). Cell proliferation was qualitatively evaluated according to the location of the expression of the immunomarker in the cell and epithelium layers and by quantitatively considering the percentage of positive cells expressed. The analysis of HPV+ carcinomas was undertaken by means of the polymerase chain reaction (PCR), having GP5+/6+ as primers for identification of the virus. The qualitative analysis showed that the immunomarking in the VC as well as in the control group was concentrated mainly in the basal and parabasal layers and the counting of the positive cells at the base of the epithelium showed a significant statistical difference in the expressions of all three markers (p<0,05). The quantitative analysis of the cell proliferation markers was calculated by means of the Mann-Whitney and Kruskal Wallis tests and through the Pearson and Spermans correlation. They pointed to differences between the SCC and VC groups for the PCNA and cyclin B1 markers (p<0,05). On considering the three groups, it was proved that there was a positive correlation between Ki67 and the cyclin B1 (r=0,56) but not between the PCNA and the Ki67. The PCNA immunomarking was greater in the control group (average=100%), and the Ki67 showed itself to be effective as a proliferation cell marker although it showed no significant difference between the carcinoma variants. Whereas the cyclin B1 showed a significant difference in the comparison between the SCC and the VC groups (p<0,05), and a positive correlation to the extent that the histological grading of the malignancy (WHO model) of the carcinomas increased (r=0,44). All tumor samples were negative for HPV. Although the lesions showed different biological behaviors, the cell proliferation index in both types of mouth carcinoma was higher than in the control group, as shown by the analysis of the Ki67 and cyclin B1 markers. On considering the total sample of carcinomas, independently of the tumor variety, cyclin B1 showed a positive correlation with the histological degree of malignancy according to WHO. There is a need for further study to be carried out in the field of cell proliferation and detection of HPV especially with regard to VC, because it is a rare variant of SCC.
Avaliação do processo de raparo de lesões periopicais pós-tratamento endodôntico por meio de subtração digital radiográfica
(Universidade Federal de Goiás, 2006-11-30) SILVA, Janaína Benfica e; ALENCAR, Ana Helena Gonçalves de; http://lattes.cnpq.br/2039898015468283; MENDONÇA, Elismauro Francisco de; http://lattes.cnpq.br/2305019128015847
Control of the process of repair or progression of periapical lesions after endodontic treatment is monitored by conventional or digital radiography. In this research digital subtraction radiography (DSR) was used that uses the subtraction of images longitudinally, in which the change in the alveolar bone is visualized against a uniform gray background. The objectives of this study were: (1) to evaluate the repair process of periapical lesions after endodontic treatment by using DSR; (2) to quantify by means of point/pixel (picture element), area (histogram) and linear measures (profile line), the gain or loss of mineral density in the area of the lesion, using the average of the pixel values; (3) to compare the diagnostic information, suggestive of the repair process, obtained through a subjective evaluation of DSR with a conventional radiographic evaluation and digitalized image and (4) to evaluate the contribution of DSR to an early identification of the repair of periapical lesions after endodontic treatment. The sample consisted of twelve patients with a total of seventeen periapical lesions. The x-rays were digitalized and submitted to DSR using DSR software. The pixel values of the subtracted images were determined by using Image Tool software. Both the conventional x-rays as well as the digitalized and subtracted images were qualitatively evaluated. The results showed a gain in mineral density with a meandp of 133.495.17, 130.275.77 and 129.414.46 for the points/pixel, histogram and profile line tools, respectively. In the evaluation of numerical gain Pearson s Coefficient of Correlation (r) presented these values: mean of points/histogram = 0.746; mean of points/profile line = 0.724 and histogram/profile line = 0.860. When the numerical values were transformed into percentile gain meandp of 0.674.01, 1.214.33 and 1.163.36 were obtained for the points/pixels, histogram and profile line tools, respectively. In the evaluation of the percentile gain Spearman s Coefficient of Correlation (rs) showed the following values: mean of points/histogram = 0.697; mean of the points/profile line = 0.646 and histogram/profile line = 0.844. In the qualitative analysis, the frequency of success in the ordering of the correct sequence of the repair process using conventional radiography, digitalized image and DSR was 37.3%, 31.4% and 31.4%, respectively. One concluded, therefore, that: (1) the process of repair of periapical lesions after endodontic treatment can be evaluated quantitatively by means of longitudinal analysis using DSR; (2) any one of the three tools can be used to quantify the repair, considering that correlation exists between the time of repair and the increase of the value of pixel; (3) the comparative evaluation between the subjective methods using conventional radiography, digitalized image and SDR, it showed that all had been capable to evidence the process of repair of periapical lesions from the first radiography (15 days), not having difference between them and (4) the quantitative evaluation by SDR obtained to after evidence the beginning of the repair with 15 days the beginning of the endodontic treatment, even so this repair was really effective from 105 days after the beginning of the endodontic treatment.
Avaliação da infiltração microbiana na interface implante-abutment em conexões tipo hexágono interno e cone-morse de implantes osseointegráveis
(Universidade Federal de Goiás, 2007-09-28) SANTANA, Washington Macedo de; PIMENTA, Fabiana Cristina; http://lattes.cnpq.br/2230554075502158; GUILHERME, Aderico Santana; http://lattes.cnpq.br/8753467344512117
The scientific literature has reported that dental implants can be affected by the oral microorganisms through the formation of a bacterial biofilm. The region most affected is the connection between the implant platform and the prosthetic abutment, particularly in implants with an external connection. Therefore, the region of the implant/abutment connection can participate in the development of peri-mucositis or peri-implantitis. They propose that these implant/abutment connections known as morse taper provide an effective seal against microorganisms. Thus the objective of this research was to evaluate the microleakage on the implant/abutment interface of internal hex and morse taper prosthetic connections. Thirty five (35) implants were selected and divided into seven (7) groups (5 groups of implants from Brazilian manufacturers and 2 groups of implants manufactured abroad). The tested implants were Straumann (Straumann AG® / Switzerland), Ankylos (Dentsply-Friadent® / Germany), AR Morse (Conexão/Sistema de Prótese® São Paulo-SP), Titamax CM (Neodent® /Curitiba-PR), Titamax II Plus (Neodent®/Curitiba-PR), Stronger (Sin/Sistema Nacional de Implante® São Paulo - SP) e Titanium Fix CM (AS Technology / São José dos Campos-SP). For the microbiological test the bacterium Enterococus faecalis (ATCC 29212) was selected. This bacterium was inoculated in the interior aspect of the implant followed by immediate installation and final torque (N/cm) of the prosthetic abutment. The implant/abutment set up was then placed in a Brain Heart Infusion broth (BHI) and incubated in this broth for 14 days. During this period, the cloudiness of the broth was evaluated at days 7 and 14. The data were statistically analyzed by the Kruskal Wallis method. The results demonstrated that all samples from both Ankylos and Neodent CM groups did not present microleakage. Although 20% of samples from Conexao AR Morse group presented microleakage, there was no significant statistical difference when compared to the former two groups. Furthermore, all samples from Straumann,Titanium Fix CM, Neodent Titamax II Plus, and SIN Strong groups presented microleakage after 14 days of culture (p=0.05), though correlation analysis among these samples did not reveal significant statistical differences.
Avaliação da satisfação e qualidade de vida dos pacientes usuários de próteses sobre implantes (protocolo e overdenture) desenvolvidas em instituições de ensino odontológico públicas e privadas
(Universidade Federal de Goiás, 2007-10-01) Braga, Michelle; Guilherme, Adércio Santana; Guilherme, Adérico Santana; Cury, Altair Antoninha Del Bel; Zavanelli, Ricardo Alexandre
The patient satisfaction is a relevant aspect that actually matters with regards to the success of the treatment. And it is also so important that it must be regarded as an imperative outcome parameter.Considering the lack of scientific studies about patient satisfaction variables and oral health–related quality of life in implant supported prothesis therapy (protocol and overdenture). Based on these concerns, the aim of this study is to evaluate the satisfaction and oral health-related quality of life in patients with fixture-retained prostheses (protocol and overdenture); then to establish comparisons between groups (protocol and overdenture) and intra-group (bar-clip and individual retainers) comparisons that were held in implant postgraduate courses of private and public institutions. This paper is a cross-sectional study and the patient selection was based on data from the patients’ files from private and public institutions. The sample consisted of 35 subjects, including males and females, with age ranging from 43 to 77, treated with implant-anchored full prostheses in the last 4 years. Fifteen patients had implant-retained complete prostheses, 19 patients had implant-supported overdentures, and from these 20, 12 had bar-clip retainers and 8 had individual retainers. The patient satisfaction variables and oral health-related quality of life were assessed through self-questionnaires and a short form of the Oral Health Impact Profile (OHIP-14). The data were gathered and estimated in a database customized specifically for the research using Windows Excel and the statistical analyses were made by SPSS for Windows (13.0). The Kruskall-Wallis test (non-usual distribution of researched data) was used and the Cronbach’s α was used for checking the reliability of the instruments. In conclusion, there were no significant statistical differences between Protocol and Overdenture groups regarding the following variables: comfort and retention; stability; prosthesis grade; esthetics; oral discomfort; functional restrictions; phonetics limitations; social limitations; and psychological discomfort (p > 0,050). Nevertheless, the group including patients treated with complete prostheses fixed by implants showed higher satisfaction scores compared to the group including patients treated with overdentures supported by implants (p = 0,049 < 0,05). In view of the oral health-related quality of life measured by OHIP-14, the overdenture group showed low impact considering functional limitation and low scores when comparing protocol group. There were no significant statistical differences in the intra-group comparisons (bar-clip retainer and individual retainer).
Estudo comparativo da densidade radiográfica de diferentes cimentos odontológicos restauradores à base de ionômero de vidro.
(Universidade Federal de Goiás, 2007-10-05) MELO, áureo Honorato e; SOUZA, João Batista de; http://lattes.cnpq.br/0642108682158061; FREITA, Gersinei Carlos de; http://lattes.cnpq.br/8530071658595530
Glass ionomer cements are generally represented by a combination of a powder, which main components are alumina (Al2O3 ), silica (Si2O3 ) and calcium fluoride (CaF2 ), and a liquid, which is an aqueous solution basically compound of polyacrilic acid and tartaric acid. Its excellent features have been described since the 1960 s, and some of these are the radiopacity and fluoride release. The aim of this work is to study the radiopacity measured by radiographic exposures of the following restorative glass ionomers: Vidrion R (SS White Manufacturing Ltd, Gloucester, England); Chemfil (DENTSPLY DeTrey, Konstanz, Germany); Vitro Molar (DFL); Maxxion R (FGM Dental products Ltd); Riva self cure powder and liquid and Riva self cure in capsules (Riva SC, SDI Ltd, Bayswater, Australia) and to make comparisons among them. Then, different radiographic densities from an aluminum scale were attained and they could be compared and used in the clinical work. The specimens were made using standard glass plates (25,4 x 76,2 x 1,0 mm) manufactured by Global Trade Technology and they were perforated by a 5mm bur (number 5, Black & Decker, Brazil) especially used for glass. For the radiopacity evaluation, the samples were radiographed using three different types of films, which are the following: Kodak Dental Intraoral ESpeed Film (EASTMAN KODAK Co., Rochester, N.Y.); Contrast DFL DV-58 (DFL Ltd); and Agfa Dentus M2 Confort (Heraeus Kulzer Inc.). A 99,5% pure aluminum step wedge and a Gnatus XR 6010 X-ray equipment were utilized in this work. The data were collected by 5 examiners, who were properly calibrated, and analyzed by Friedman and Kolmogorov-Smirnov tests. The results showed no statistical differences among the averages of each examiner comparing the cements and the films. And the results also showed that all the cements present radiographic density average values below 1.
Integralidade e saúde bucal na percepção de participantes dos movimentos sociais do SUS
(Universidade Federal de Goiás, 2007-10-19) NOVAIS, Tatiana Oliveira; MARCELO, Vânia Cristina; http://lattes.cnpq.br/6650368201862218
Integrality is a principle of the Brazilian Unified Health System (SUS) defended by the sanitary reform movement. It is a polysemic and democratic term for it considers several perceptions. For that reason, other kinds of knowledge were included in this paper in addition to the scientific one. Oral health can also be understood in various ways, since its limited meaning of mouth until a collective notion regarding health promotion precepts. Therefore it is possible to discuss integrality focusing on oral health. This research aims to identify possibilities for action seeking integrality for oral health in SUS and in social movements, according to their participants perceptions. Key people in knowledge building were selected to be interviewed, connecting scientific and popular knowledge, SUS and social movements participants. The methodology used was qualitative research and content analysis. The findings were divided into four categories: different meanings of integrality, perceptions of oral health in SUS, perceptions of oral health in social movements and possibilities for actions. Each category was then subdivided into subcategories. The main conclusions about the action possibilities are those related to re-integration, allowing a re-totalizing paradigmatic posture of the reality, the use of problem based learning strategies both in professional forming and in permanent education of SUS workers, building public policies and health models of attention aiming the integrality. Although health promotion was not described as a specific category, it undergoes most possibilities for actions mentioned, acting as a structural framework.
Manual de biomecânica - introdução aos conceitos da mecânica ortodôntica
(Universidade Federal de Goiás, 2007-10-29) Lenza, Maurício Guilherme; Souza, João Batista de; http://lattes.cnpq.br/0642108682158061; Lenza, Marcos Augusto; http://lattes.cnpq.br/0734929669869820; Lenza, Marcos Augusto; Freitas, Gersinei Carlos de; Ferreira, Flávio Augusto Cotrim
Understanding of the applied mechanics to biological bases and the ability of utilizing this knowledge in clinical situations are of extreme importance for a successful orthodontic treatment. The science that studies and analyzes the mechanics of living organisms is known as Biomechanics. For a better understanding of the biomechanical principles applied in orthodontics, this subject was summarized in this product, gradually presented and widely illustrated, from the basic concepts of biomechanics to moment-to-force ratios. The purpose of this work is to approach and explain the biomechanical principles, so that students, general practioners and specialists can understand its practical potential in orthodontics, establishing a greater interaction between the exact sciences (mechanics) and the biological sciences (dentistry).
Avaliação da citotoxicidade dos extratos da corrosão de mini-implantes ortodônticos de TI- 6AL-4V após imersão em saliva artificial fluoretada por 30, 90 ou 180 dias
(Universidade Federal de Goiás, 2008-02-25) Lemes, Sandra Stival dos Santos; Souza, João Batista de; Lenza, Marcos Augusto; http://lattes.cnpq.br/0734929669869820; Lenza, Marcos Augusto; Janson, Guilherme dos Reis Pereira; Dias, Fátima Ribeiro
The alloys used in the orthodontic therapy are subject to the corrosion process in the oral environment. Orthodontic mini-implants Ti-6Al-4V are an excellent source for intraoral anchorage; however, their corrosion resistance in the presence of fluoride is currently unknown. The purpose of this in vitro study was to evaluate the cytotoxic effects of the corrosion extracts of mini-implants Ti-6Al-4V from three different manufacturers when exposed to 200 g/L of sodium fluoride containing artificial saliva for 30, 90 or 180 days. The cytotoxic effects of their corrosion products on L929 cell culture was evaluated by MTT (3- [4,5-dimethylthiazol-2-yl]2,5-diphenyltetrazolium bromide) assay, for cell metabolism and proliferation. The extracts were not cytotoxic and the cytotoxicity assay demonstrated a similar behavior for the samples immersed in artificial saliva in the three evaluated periods. The qualitative analysis, through SEM did not show characteristics of corrosion. The results indicated that the mini-implants tested presented a high corrosion resistance and biocompatibility.
Motivos determinantes da eleição ou recusa de tipos de tratamentos protéticos em desdentados parciais
(Universidade Federal de Goiás, 2008-03-03) MARTINS, Rafael Ragonezi; LELES, Claudio Rodrigues; http://lattes.cnpq.br/6740286066154410
The aim of the study was to explore preferences and reasons for choosing or refusing prosthetic treatments in partially edentulous patients. Clinical and oral-related quality of life measures were collected from 165 patients undergoing dental treatment in undergraduate clinical activities in the School of Dentistry of the University Federal of Goiás. Reasons for choosing or refusing prosthetic treatments were investigated using an instrument containing 32 questions about the importance of these items for the patient s decisions about treatment in a 5-point Likert scale, ranging from 1 (no importance) until 5 (absolutely important). Descriptive statistics, chi-square and ANOVA were used to compare patients preferences according to clinical independent variables. Discriminant analysis was used to analyze the impact of patients reasons for choosing or refusing removable (RPD), fixed (FD) or implant (ID) prosthesis. Results showed that older patients (p<0.001) and with greater OHIP scores (p<0,05) were more likely to choose for removable partial dentures and implant prosthesis were preferred in patients with higher school levels (p<0.01). Discriminant functions reveal that the desire of having a fixed or removable appliance had great impact on patients decisions. The removal of natural teeth structure was the main reason for refusing conventional fixed dentures and cost had great impact on refusing implant dentures. Overall agreement percentages between actual patients decisions and predicted by discriminate analysis were over 90% for all types of treatment. It was concluded that acceptance or rejection of prosthodontic modalities have great variations among patients and individual perceptions are important determinants of treatment decisions. The main reasons for choosing or refusing treatments focused in this study can be used to guide shared decision making process, providing treatments that better match patients expectations and desires
Análise das relações de poder na política nacional de saúde bucal: o dito e o visto
(Universidade Federal de Goiás, 2008-04-08) ANDRADE, Flávia Reis de; MARCELO, Vânia Cristina; http://lattes.cnpq.br/6650368201862218
In order to consolidate the principles underlying the Brazilian Unified Health System (Sistema Único de Saúde SUS) and with the aim of acting on evidence arising out of epidemiological research in dental health, the Ministry for Health decided to structure the National Policy for Dental Health (NPDH). This study sets out to analyze the power relationships in the drawing up of the NPDH. It is a descriptive study which uses the qualitative method as its approach. The data was obtained through individual semi-structured interviews with 15 participants. The content analysis technique was used for the interpretative examination of the material transcribed. The following categories emerged: participant actors, type of participation, initial outline, (re)discussion lists, political context, present impasses and perspectives. The participant actors were divided into two groups: individual and collective. The former, a coherent group, was made up of people who identified with the victorious political project of the 2002 presidential elections, and who had undoubtedly struggled to build the SUS. It was the task of the second group to give approval to what the first had expounded. The interviewees were influential in the shaping of the NPDH, both through the research they undertook (academy) and through the movements in which they participated (services, militancy). It is impossible to define precisely the moment when the drawing up of the NPDH started, as it was a slow process taking place over at least a quarter of a century. The most visible milestone for the beginning of the broad official and unofficial debates which outlined the Policy, was the result of a series of reflections starting with the Movement for Sanitary Reform. Thus, the NPDH is made up of a set of deliberations arising out of different moments of discussion, but especially the meeting held in the Municipality of São Paulo, following on the election results of Luiz Inácio Lula da Silva s campaign for Presidency of the Republic in 2002. This meeting defined the proposal presented to the members of the Governmental Transition Commission and it marked the beginning of a period of intense normative work by the Health Ministry s Advisory Commission to the National Coordination of Dental Health. This resulted in the drawing up of a document entitled Guidelines on the National Policy for Dental Health , ratified by the 3rd National Conference on Dental Health. The NPDH now presents symptoms of growth as well as those of early degeneration. As potential internal weaknesses, one can cite the improper management of financial resources in particular and the growing tendency of the NPDH to be characterized as a provider of specialized odontological services. However, the greatest preoccupation is that the people who did not in fact participate in drawing up the Policy (for lack of opportunity) are today the pillars of its consolidation. Those who try to understand the process of drawing up the NPDH frequently come up against the nouns group and consensus. This therefore shows a clear approximation to the Arendtian concept of power. However, the present preoccupying indexes of the internal degeneration of the Advisory Commission would point towards another form of power in the implantation phase of the National Policy for Dental Health.
Retenção de grampos cirucenferenciais associados a retentores intra-radiculares com encaixe era utilizados em overdentures parciais removíveis
(Universidade Federal de Goiás, 2008-07-18) SOUZA, José Everaldo de Aquino; ZAVANELLI, Ricardo Alexandre; http://lattes.cnpq.br/6610989896574204
The overdentures can be defined as total or partial removable dentures that cover root or osseo integrated implants rehabilitating the whole dentition. The mechanical retention in the removable partial overdentures (RPOs) is obtained through the use of cast clasps and attachments. This biomechanical principle has a great importance, since is inwardly associated with long term behavior and clinical performance of prosthesis and consequently, with comfort and satisfaction of the patients. So, the aim of this study was to assess the retention of metallic framework with simple circumferential claps associated intraradicular retainer with attachment type ERA (Extra coronal Resilient Attachment, Sterngold Implamed, Attleboro, EUA) in function of the metals based cobalt-chromium alloy (Co-Cr), titanium commercially pure (Ti cp) and nickel-chromium with titanium alloy (Ni-Cr with Ti), of the retentive undercuts of 0,25mm and 0,75mm and in function of the time of use in each simulated period (initial, 6 months, 1, 2, 3, 4 e 5 years). Through of metallic matrices representing a partially edentulous mandibular right hemi-arch segment constituted by the crown of the first molar, root of the inferior canine and with the absent of the premolars, were made 60 metallic frameworks being obtained 03 groups of each metal and subgroups representative of the 0,25mm and 0,75mm retentive undercuts of the circumferential clasp (totalizing 10 samples in each subgroup). Acrylic denture bases were constructed on the denture space and on the canine root that anchored the attachments and these received retentive capsules in the gray color of the system. Previously the mechanic tests, radiographic exams of the Ti cp frameworks were realized with the aim of detecting possible casting defects that could avert the posterior use. Next, the samples were mechanically tested simulating the insertion and removal of the framework using the testing apparatus designed at the Ribeirão Preto School of Dentistry (Testing apparatus, São Paulo University, Ribeirão Preto, Brazil), representing 5 years of simulated used. To simulate the intraoral conditions and realize the tests, a gadget fulfilled with artificial saliva was adapted in the testing apparatus. The retentive force data were recorded and submitted linear regression analysis and analysis of variance (ANOVA) to gauge a presence or not of significant differences and applied the Tukey complementary test 5% to comparison of the differences between the groups and subgroups. The groups of Ni-Cr with Ti and Co-Cr samples obtained most retentive mean with significant differences to group of Ti cp samples that obtained least retentive mean in every periods of time analyzed. To groups Ni-Cr with Ti and Co-Cr samples there was not significant difference of retention between the times analyzed free-standing of retentive undercuts (p > 0,05). In the group Ti cp samples there was significant difference of retention between the times analyzed just to subgroup samples with 0,75mm undercuts (p < 0,05). The Ni-Cr with Ti and Co-Cr samples with 0,75mm undercuts presented the most retentive mean and the Co-Cr samples with 0,25mm undercuts presented retention mean intermediate between biomechanical design in every periods of time analyzed. The Ti cp samples with 0,25mm undercuts presented the least retentive mean until second year of the analyze and the Ti cp samples with 0,75mm undercuts presented the least retentive mean of third until fifth year of the analyse. The circumferential claps casting in Ti cp used in 0,75mm undercuts have potential risk of fractures, mainly after the 2o year of use
Avaliação de deiscência e fenestração por meio de tomografia computadorizada volumétrica em pacientes com maloclusão de Classe I e Classe II Divisão 1
(Universidade Federal de Goiás, 2009-01-16) Arruda, Karine Evangelista Martins; Silva, Maria Alves Garcia Santos; http://lattes.cnpq.br/8760691456576488; Silva, Maria Alves Garcia Santos; Almeida, Guilherme de Araújo; Mendonça, Elismauro Francisco de
The effects of orthodontic treatment on periodontal structures have been studied in literature, especially regarding the integrity of alveolar bone and gingival health of the teeth to be displaced. The aim of this study was to evaluate the presence of alveolar defects (dehiscence and fenestrations) in patients with Class I and Class II division 1 malocclusions and in different facial types using cone beam computed tomography (CBCT). The sample comprised 159 tomography exams of patients with no previous orthodontic treatment, giving a total of 4319 teeth. The presence or absence of dehiscence and fenestration in the buccal and lingual surfaces was checked in axial and crosssectional views. The results showed that 155 patients (96.9%) presented some type of alveolar defect. The Class I malocclusion patients presented higher prevalence of dehiscences (35%) than those with Class II division 1 malocclusion. There was no statistically significant difference between the facial types. Lower incisors, lower canines and lower first premolars were respectively the teeth with more occurrences of alveolar defects. This study concluded that CBCT is indicated for patients who need extensive tooth movement and have unfavorable gingival biotype.
Efeito da aplicação do gás ozônio na resistência de união entre resina composta e dentina
(Universidade Federal de Goiás, 2009-03-13) RODRIGUES, Paula Cicília Faquim; SOUZA, João Batista de; http://lattes.cnpq.br/0642108682158061
The aim of this study was to evaluate the effect of ozone gas and its use with an antioxidant on the resin-dentin microtensile bond strength. The oclusal enamel of forty human third molars was then removed to expose a flat superficial dentin surface. The teeth were randomly divided into four groups (n = 10): (G1) untreated dentin with ozone (control group); (G2) ozone gas application for 40 s followed by acid etching; (G3) acid etching followed by ozone gas for 40s; and (G4) ozone gas for 40s with subsequent application of sodium ascorbato 10% for 10 min. Composite build-ups were constructed incrementally. Specimens were sectioned to obtain sticks with cross-sectional areas of 1mm2 to be tested in tension (0.5 mm/min). The microtensile bond strength values were analyzed by one-way ANOVA and Tukey s test (α=0.05). All sticks fractured were then observed under a stereomicroscope (40X). The results showed that the G1 had higher values of microtensile bond strength when compared to G2 and G3 (p=0.00). The values of microtensile bond strength of G1 and G4 were similar (p = 0158) and higher than the G2, but there was no difference between the values of G3 and G4 (p=0,115). The use of ozone prior to etching (G2) resulted in lower value of microtensile bond strength in all conditions evaluated (p = 0.00). The application of ozone gas decreased the microtensile bond strength of the interface dentin/composite resin, but the values were reversed when the use of sodium ascorbate
Comparação entre implantes unitários de superfície tratada e não tratada por sub-tração radiográfica digital em protocolos de carga imediata e convencional
(Universidade Federal de Goiás, 2009-03-27) CARNEIRO, Luciano Sandoval; MENDONÇA, Elismauro Francisco de; http://lattes.cnpq.br/2305019128015847
Objectives: To compare by digital subtraction radiography (SR), matched to clinical evaluation, bone response to single-tooth treated (TS) and non-treated (NTS) surface implants on immediate (IM) and conventional (CO) loading protocols. Material and methods: 12 patients (8 underwent IM protocol and 4 underwent CO protocol) received 24 implants. Each subject received 2 implants (one with TS and the other NTS) homologously and bilaterally positioned in maxillae (lateral incisor, canine or premolar regions) or mandible (molar area). Standardized radiographies of each implant were taken on the day after implant placement (baseline image) and after 3, 6 and 12 months (follow-up images). SR was used for crestal bone loss (CBL) and peri-implant bone density (PIBD) measurements. The placement torque and resonance frequency (at 0, 6 and 12 months) were also measured for matching radiographic data. Results: T-test revealed no statistically significant difference in CBL between TS and NTS implants, while TS implants presented higher PIBD in the mid-implant region at 3-months recall (p = 0.04). For IM protocol, the Mann-Whitney test revealed higher CBL at 6-months follow-up (p = 0.03), greater PIBD at 12-months recall (p = 0.06; p = 0.07) and increasing PIBD through time. There was a positive correlation between primary stability and PIBD at 12-months recall (r = 0.58; p = 0.005). Conclusions: TS and NTS implants presented similar performances with regard to CBL and PIBD. IM and CO protocols were similarly successful. Primary stability was an important element in reaching greater PIBD after 1-year loading period
EFICÁCIA DE DIAGNÓSTICO DA TOMOGRAFIA COMPUTADORIZADA E RESSONÂNCIA MAGNÉTICA NO TRATAMENTO DAS DESORDENS DA ARTICULAÇÃO TEMPOROMANDIBULAR: UMA REVISÃO SISTEMÁTICA
(Universidade Federal de Goiás, 2009-04-22) MARQUES, Karlla Dias Siqueira; RIBEIRO-ROTTA, Rejane Faria; http://lattes.cnpq.br/9466795079344876
Diagnosis of disorders affecting the temporomandibular joint (TMJ) is a difficult task for many reasons. These include the structural and functional complexity of this joint, the multifactorial origin of these disorders and limited knowledge of their natural course, the presence of common symptoms among its various subclasses and other craniofacial conditions. If the premise for effective treatment is a correct diagnosis, it is clear that the treatment of these disorders is not any less complex than their diagnosis. The aim of this study was to do a systematic analysis of the literature in relation to proof of the therapeutic efficacy of computed tomography (CT) and magnetic resonance imaging (MRI) in the treatment planning of TMJDs (disc displacement, inflammatory disorders without systemic involvement or osteoarthosis). This systematic review was comprised of three steps: (1) Specifying the problem and the inclusion/exclusion criteria used in the publications; (2) Formulation and detailing of a plan to conduct the literature search; (3) Interpretation and integration of the evidence in the studies and formulation of recommendations based on the quality of the evidence. The bibliographical search was undertaken in PubMed and Cochrane Library databases from January 1966 to July 2009, using specific indexed terms, selected according to the objectives. The titles and abstracts found were analyzed by three examiners and the publications fulfilling the inclusion criteria were selected. The same three examiners read the full texts of these selected publications, and extracted data with the help of a previously drawn up protocol. A publication was considered relevant and included in the review when its results expressed any type of impact of the information obtained with CT and MRI on the treatment of disc displacement, local inflammatory disorders or osteoarthosis therapeutic efficacy. Publications considered relevant were interpreted with the aid of the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool and publications that critically evaluate systematic reviews. Results: The literature search yielded 584 titles and abstracts, of which 257 were selected and read in full text. One study was judged relevant. This study evaluated evidence of the efficacy of magnetic resonance imaging (MRI) in the diagnosis of disc position and configuration, disc perforation, joint effusion, and osseous and bone marrow changes in the temporomandibular joint, but no publication reported diagnostic thinking efficacy or therapeutic efficacy. The absence of studies on the therapeutic efficacy of CT and MRI on TMJD reinforces the need for investment in decision-making studies; meanwhile, sectional imaging tests should be prescribed with caution, especially when health budgets are limited.
Expressão da proteína Ki-67 e da glicoproteína MUC1 em carcinomas mucoepidermóide de glândulas salivares menores
(Universidade Federal de Goiás, 2009-05-22) GONÇALVES, Cintia Ferreira; BATISTA, Aline Carvalho; http://lattes.cnpq.br/0199082642322002; MENDONÇA, Elismauro Francisco de; http://lattes.cnpq.br/2305019128015847
Aims: Investigate the prognostic significance of cellular proliferation indexes and mucosecretional activity in Mucoepidermoid Carcinoma (MEC) of oral cavity minor salivary glands using the immunoexpression of the protein Ki-67 and the glycoprotein MUC1 in young people and adults, by correlating these markers to clinical and pathological parameters. Material and methods: From 1987 to 2007, 35 cases of MEC were diagnosed in minor salivary glands. Demographic clinical data were obtained from clinical records, the microscopic diagnosis was revisited and the specimens were reclassified in terms of histologic grading, according to the system used by Batsakis & Luna (1990). Qualitative and quantitative analyses of the expression of Ki-67 protein and MUC1 glycoprotein, obtained through immunohistochemistry, were correlated to the variables: age, gender and histologic grading. Results: The cases of MEC (n=35) were more frequently found in people over thirty (60%), with predilection for females (1.7:1) and occurred most frequently in the hard palate (54.3%). Of the cases studied, 42.9% were low grade, 37.1% intermediate and 20% high grade. A greater expression of Ki-67 was found for adults while the greater expression for young people was MUC1, although neither result was statistically significant (Ki-67 / P=0.44 e MUC1 / P=0.5). In addition no prognostic relation was seen between male and female, despite the greater expression of both markers for males (Ki-67 / P=0.58; MUC1 / P=0.4). In terms of histologic grading intermediate and high grade tumors presented a greater expression for both markers, but without any statistical significance (Ki-67 / P=0.18; MUC1 / P=0.6). Conclusions: MEC in minor salivary glands could present a tendency of lesser aggressiveness in younger patients when compared to adults; in females when compared to males, and in tumors of low histologic grade when compared to those of intermediate or high grade. Furthermore, this tumor may have a tendency to higher mucossecretory activity in young than in adults, in males than in females and in intermediate and high grade tumors.

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