Programa de Pós-Graduação em Odontologia
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Doctoral Thesis Comparação do enxerto de tecido conjuntivo e de uma matriz de colágeno xenógena no recobrimento radicular de recessões gengivais unitárias em fenótipo gengival fino(2019-05-23) Menezes, Karyna de Melo; Gurgel, Bruno César de Vasconcelos; ; ; Dantas, Euler Maciel; ; Nobrega, Fernando José de Oliveira; ; César Neto, João Batista; ; Lins, Ruthineia Diógenes Alves Uchoa;Gingival recession may cause dental hypersensitivity, esthetical discomfort and increase the prevalence of carious or non-carious cervical lesion. Root coverage procedures using grafts placement has been the gold standard on this treatment. AIM: To compare the root coverage performed connective tissue graft and collagen matrix using the extended flap technique in single gingival recessions in thin gingival phenotype, at 6 months of followup. METHOD: This controlled, randomized, double-blind, split-mouth, clinical trial evaluated 28 patients with bilateral gingival recession subjected to root coverage procedure through extended flap technique with subepithelial connective tissue graft (control) and xenogenic collagen matrix (test). The parameters evaluated were deep on probing, gingival recession, clinical attachment level, keratinized mucosa and bleeding on probing for teeth that received the graft and the distal and mesial teeth. In addition, gingival thickness and gingival phenotype change of the teeth that received the grafts, postoperative pain and quality of life through Oral Health-Related Quality of Life, at baseline, three and six months after surgery. The data were statistically analyzed through the tests of Friedman, Wilcoxon, Mann-Whitney, Qui-quadrado, McNemar, ANOVA and t Test. The significance level of 5% was pre-estlablished. RESULTS: 14 men and 14 women were included, with an average of 30.3 years (± 6.2). Statistically significant reductions were observed for gingival recession and clinical attachment level significant increase of both teeth of the grafts (p <0.001), distal (p=0.001) and mesial (p<0.001) teeth, within each group and in both treatment groups, during the follow-up. In addition, there was keratinized mucosa significant increase (p <0.001) and gingival thickness (p<0.001) for test and control group, respectively, with statistical difference between groups. The treatment protocol was able to improve the quality of lite (p<0.001). CONCLUSION: Both treatments resulted in improved clinical parameters at six months of follow-up. The collagen matrix represents an excellent alternative to the subepithelial connective tissue graft in the treatment of single gingival recessions in thin gingival phenotype.Doctoral Thesis Análise da imunoexpressão de proteínas de reparo do DNA envolvidas nas vias BER e NER em lesões odontogênicas epiteliais benignas(2019-06-04) Santos, Hellen Bandeira de Pontes; Freitas, Roseana de Almeida; ; ; Nonaka, Cassiano Francisco Weege; ; Godoy, Gustavo Pina; ; Galvão, Hebel Cavalcanti; ; Souza, Lelia Batista de;The benign epithelial odontogenic lesions present a heterogeneous biological behavior and their pathogenesis are not fully understood. The deoxyribonucleic acid (DNA) repair pathways act on specific types of damage to the genetic material, performing the repair and regulating several cellular processes. Among the main DNA repair pathways, the most notable are the base excision repair (BER) and the nucleotide excision repair (NER). Investigations have shown that the proteins involved in these pathways are deregulated and sometimes highly expressed in some malignancies, contributing to tumor progression. Taking into account the heterogeneity of the biological behavior of benign epithelial odontogenic lesions and the scarcity of studies that have evaluated the expression of DNA repair proteins in these lesions, this study evaluated the immunoexpression of BER (APE-1 and XRCC-1) proteins and NER (XPF) in solid ameloblastomas (AMEs) (n = 30), non-syndromic odontogenic keratocysts (NSOKCs) (n = 30), syndromic odontogenic keratocysts (SKOCs) (associated with Gorlin's Syndrome) (n = 29), dentigerous cysts (DCs) (n = 30) and dental follicles (DFs) (n = 20). The immunohistochemical analysis of APE-1, XRCC-1 and XPF was performed quantitatively by a previously calibrated evaluator and without access to the clinical data of the cases. In five fields of higher immunoreactivity, positive and negative cells were quantified for the proteins in the epithelial component of all cases, and the percentage of positive cells was established in relation to the total number of cells counted for each antibody. Nuclear and cytoplasmic markers were analyzed separately for APE-1 and XPF, while only nuclear immunoexpression was considered for XRCC-1. The comparisons of the median percentages of immunoreactivity in relation to the studied groups were performed using the non-parametric Kruskal-Wallis and MannWhitney tests. Possible correlations between the expression of APE-1, XRCC-1 and XPF were assessed by Spearman's correlation test. The level of significance was set at 5% (p < 0.05). A higher nuclear immunoexpression of APE-1 in the NSOKCs, SOKCs and solid AMEs was verified in comparison with the DCs (p < 0.001). Among all the evaluated groups, the cytoplasmic expression of APE-1 was only found in 4 NSOKCs and 6 SOKCs. Nuclear expression of XRCC-1 was statistically higher in NSOKCs and SOKCs than in DCs (p < 0.05). At the nuclear level, XPF expression was significantly higher in NSOKCs and SOKCs than in DCs and AMEs (p < 0.05) and, although without statistical significance, a higher nuclear expression of this protein was observed in AMEs when compared to CDs. Regarding the cytoplasmic expression of XPF, a greater expression was observed in the SOKCs in relation to the DCs (p = 0.04). No statistically significant difference was found between the nuclear expressions of APE-1, XRCC-1 and XPF between NSOKCs and SOKCs (p > 0.05). In addition, all the odontogenic lesions studied revealed a statistically significant expression of APE-1 (nuclear), XRCC-1 (nuclear) and XPF (nuclear and cytoplasmic) when compared to DFs (p < 0.05). For all lesions, Spearman's correlation test showed a positive correlation between nuclear expression of APE-1 and XRCC-1 or XPF at the nuclear level (p < 0.05). The results of this study suggest a potential involvement of APE-1, XRCC-1 and XPF proteins in the pathogenesis of benign epithelial odontogenic lesions. The role played by these proteins may be more important in odontogenic lesions with more aggressive biological behavior.Master Thesis Conhecimento sobre ergonomia no âmbito acadêmico: um estudo com alunos e professores de Odontologia(Universidade Federal do Rio Grande do Norte, 2011-04-25) Cunha, Cristiane Assunção da Costa; Costa, Iris do Céu Clara; ; http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4794938J9; ; http://lattes.cnpq.br/4448410408529616; Noro, Luiz Roberto Augusto; ; Medeiros, Lis Cardoso Marinho; ; http://lattes.cnpq.br/4773333384743803Master Thesis Avaliação dos níveis de proteína C-reativa ultra-sensível em pacientes com periodontite crônica severa generalizada e sem periodontite(Universidade Federal do Rio Grande do Norte, 2007-10-29) Bezerra, Candice de Freitas Rêgo; Carreiro, Adriana da Fonte Porto; ; http://lattes.cnpq.br/6618350120004415; ; http://lattes.cnpq.br/1697268771531766; Lins, Ruthnéia Diógenes Alves Uchôa; ; http://lattes.cnpq.br/4462076152744400; Seabra, Eduardo Gomes; ; http://lattes.cnpq.br/6218058757798526INTRODUCTION: The high sensitivity C-reactive protein (hsCRP) constitutes an inflammatory mediator used as predictor of cardiovascular risk that comes being researched as indicative relation factor between cardiovascular and periodontal diseases. PROPOSITION: To compare serumals levels of C-reactive protein between patients with and without generalized severe chronic periodontitis. METHODOLOGY: A seccional study was realized using a sample with 62 patients, being 31 participants carriers of periodontal diseases (Group I) and 31 without periodontal diseases (Group II), grouped to the pairs by age and sex. As inclusion criterio were selected patients with diagnosis of generalized severe chronic periodontitis, being preculeds, individuals which presented systemic disease, recent infection history, historical of CVA or stroke, smokers, pregnants and lactants. The research consisted of two stages, a clinc and other biochemist. The clinical stage is constituted of periodontal examination and the biochemist stage, of the peripheral blood collection for determination hsCRP levels and a hemogram to inquire any panel which could suggest infectious and/or inflammatory process. RESULTS: Periodontal disease group presented a average of 0,36mg/dL, while the group without disease presented 0,17 mg/dL, do not existing significant difference statistically between the averages (p = 0,061). The cardiovascular risk for the group I was classified high for 27,6% of participants and low for 72,4% of them. In the group II, 6,45% presented high risk e 93,5% low risk, being this significant relation statistically gotten for Fisher s Test (p = 0,042) presenting OR = 5,33; IC = 95% (1,02 27,4). The independets variables reseacred do not presented significant association statistically with the levels of hsCRP. CONCLUSION: The study indicated that despite of carriers patients of periodontal diseases do not present differents serumals levels of hsCRP from the other group, the periodontal disease was considered as risk factor for hsCRP plasmatic levels elevationMaster Thesis Impacto do Programa de Saúde da Família sobre indicadores de saúde bucal na população de Natal -RN(Universidade Federal do Rio Grande do Norte, 2007-07-14) Patrício, Alberto Allan Rodrigues; Oliveira, Angelo Giuseppe Roncalli da Costa; ; http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4794935P9&dataRevisao=null; ; http://lattes.cnpq.br/0291931404296013; Cangussu, Maria Cristina Teixeira; ; http://lattes.cnpq.br/7253292428230612; Souza, Elizabethe Cristina Fagundes de; ; http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4784162H0&dataRevisao=nullThe aim of this study was to assess the impact of the Family Health Program (FHP) on a number of oral health indicators in the population of Natal, Brazil. The study is characterized as a quasi-random community intervention trial. The intervention is represented by the implementation of an Oral Health Team (OHT) in the FHP prior to the study. A total of 15 sectors covered by the FHP with OHT were randomly drawn and paired with another 15 sectors, based on socioeconomic criteria, not covered by the teams. A few sectors were lost over the course of the study, resulting in a final number of 22 sectors, 11 covered and 11 not covered. We divided the non-covered areas into two conditions, one in which we considered areas that had some type of assistance program such as the Community Agents Program (CAP), FHP without OHT, BHU (Basic Health Unit) or no assistance, and the other, in which we considered areas that had only BHU or no assistance. Community Health Agents (CHAs) and Dental Office Assistants (DOAs) applied a questionnaire-interview to the most qualified individual of the household and the data obtained per household were transformed into the individual data of 7186 persons. The results show no statistical difference between the oral health outcomes analyzed in the areas covered by OHT in the FHP and in non-covered areas that have some type of assistance program, with a number of indicators showing better conditions in the non-covered areas. When we considered the association between covered and non-covered areas under the second condition, we found a statistical difference in the coverage indicators. Better conditions were found in covered areas for indicators such as I have not been to the dentist in the last year with p < 0.001 and OR of 1.64 and I had no access to dental care with p < 0.001 and OR of 2.22. However, the results show no impact of FHP with OHT on preventive action indicators under both non-covered conditions. This can be clearly seen when we analyze the toothache variable, which showed no significant difference between covered and non-covered areas. This variable is one of the most sensitive when assessing oral health programs, with p of 0.430 under condition 1 and p of 0.038 under condition 2, with CI = 0.70-0.90. In the analysis of health indicators in children where the proportion of deaths in children under age 1, the rate of hospitalization for ARI (Acute Respiratory Infections) in those under age 5 and the proportion of individuals born underweight were considered, a better condition was found in all the outcomes for areas with FHP. Therefore, we can conclude that oral health in the FHP has little effect on oral health indicators, even though the strategy improves the general health conditions of the population, as, for example child healthMaster Thesis Eficácia do cimento de ionômero de vidro como selante oclusal sobre a paralisação de lesões cariosas em dentina(Universidade Federal do Rio Grande do Norte, 2007-03-30) Silveira, Ana Daniela Silva da; Pinheiro, Isauremi Vieira de Assunção; ; http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4704454U5; ; http://lattes.cnpq.br/2723261181723326; Montes, Marcos Antonio Japiassú Resende; ; http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4730769Z6; Ferreira, Maria ângela Fernandes; ; http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4767285D3Dental caries consists in a multifactorial and dynamic process. The knowledge of the ionic interactions among dental tissues and dental biofilm make possible its understanding as a process that can be stopped. Recently, the use of sealants have lost its function as preventive agent and passed to be argued as a possible therapeutical agent. This happens by hindering the substratum flow to the lesion inner and, therefore, controls the advance of the process. This study aimed to evaluate glass ionomer cement as a not invasive technique of treatment in occlusal caries without clinical cavitation, but with dentinal involvement. The research was accomplished using a controlled clinical trial with two groups (experimental and control) in 38 subjects (8-18 years) with 51 molars. The teeth of the experimental group were sealed with glass ionomer cement (Vidrion-R, S.S.White, Juiz de Fora, Brazil) and the molars control did not suffer intervention. The experimental group was followed by a year and the control by 8 months due the progression of the carious injury. Both groups were reevaluated to each 4 months with the use of clinical, radiographic and laser fluorescence (DIAGNOdent®) examination. The analysis of the clinical evaluation did not observe a significant difference between experimental and control groups. However, analysis with radiographic and laser fluorescence (DIAGNOdent®) examination observed a significant difference (p> 0,05) between groups, demonstrating a wors condition to the group without intervention. The results suggest that glass ionomer cement as sealant can be efficient to paralyze dentinal caries without clinical cavitationMaster Thesis Avaliação da saúde bucal na atenção básica: a perspectiva do usuário(Universidade Federal do Rio Grande do Norte, 2007-04-30) Soares, Samara Carollyne Mafra; Costa, Iris do Céu Clara; ; http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4794938J9; ; http://lattes.cnpq.br/5483812147083198; Jesuíno, Jorge Correia; Ferreira, Aurigena Antunes Araújo; ; http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4792980U2Nowadays, the basic attention in health works according to the Health Family Program (HFP), which is responsible for the organization of the health services with view to provide an appropriate attendance to the needs of the population. Its expansion is expressive in whole country and, the oral health, included in this process, has been seen as a possibility of change the health practices centered in the disease. In face of this perspective, the proposal of study is to discover possible changes in the health care model of oral health in a district, made possible through the perception, evaluation and degree of satisfaction of the user s health service. To reach such objectives, the district of Macaíba in the State of Rio Grande do Norte, was chosen for operational subjects, such as time of implantation of HFP and great covering of this program. The current research used interviews structured with objectives and subjectives questions and questionnaires of socioeconomic characterization addressed to two hundred and seventy (270) individuals (ninety users of an Urban PSF, ninety of a Rural PSF and ninety of an unit non PSF). The analysis of the data was accomplished through the software SPSS/99, that made possible a statistical and analytic appreciation. The HFP units and non HFP units has shown to sort the common odontology problems of the community, and this didn't establish a direct relationship with the general satisfaction. On the other hands, the programmed consultation is related with lager satisfaction of the users. The access form to the odontology treatment of the Units, the satisfaction with the attendance rendered by the dentist and the equip, enough dentists for the community and the social class of the user were decisive for the general satisfaction with the service of oral health. On the other hand, variables as age and education, resolution of the problem and physical conditions of the unit didn't influence the general satisfaction. In spite of the progresses in the implantation of the oral health in ESF, preventive activities, visits at home, access and social participation still reproduce the traditional model of attendance, showing a primary change processMaster Thesis Prevalência e susceptibilidade antimicrobiana de Staphylococcusspp. em quadros de saúde e doença periodontal(Universidade Federal do Rio Grande do Norte, 2007-02-26) Santos, Bruna Rafaela Martins dos; Melo, Maria Celeste Nunes de; Lima, Kenio Costa de; ; http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4723244A9; ; http://lattes.cnpq.br/0580551464788795; ; http://lattes.cnpq.br/2611005967205110; Soares, Maria José dos Santos; ; http://lattes.cnpq.br/0555075046479252; Seabra, Eduardo Gomes; ; http://lattes.cnpq.br/6218058757798526The aim of this study was determine the prevalence and antimicrobial susceptibility of Staphylococcus spp. from patients with periodontal disease and periodontally healthy, correlate them with factors to host, local environment and traits of the diseases. To this, thirty adults from 19 to 55 years old were selected. They had not periodontal treatment and no antibiotic or antimicrobial was administered during three previous months. From these individuals, sites periodontally healthy, with chronic gingivitis and/or periodontitis were analyzed. Eighteen subgingival dental biofilm samples were collected through sterile paper points being six from each tooth randomly selected, representing conditions mentioned. They were transported to Oral Microbiology laboratory, plated onto Mannitol Salt Agar (MSA) and incubated at 370C in air for 48 h. Staphylococcus spp. were identified by colonial morphology, Gram stain, catalase reaction, susceptibility to bacitracin and coagulase activity. After identification, strains were submitted to the antibiotic susceptibility test with 12 antimicrobials, based on Kirby-Bauer technique. To establish the relation between coagulase-negative Staphylococcus (CSN) presence and their infection levels and host factors, local environment and traits of diseases were used Chi-square, Mann-Whitney and Kruskal-Wallis tests to a confidence level of 95%. 86,7% subjects harbored CSN in 11,7% periodontal sites. These prevalence were 12,1% in healthy sites, 11,7% in chronic gingivitis, 13,5% in slight chronic periodontitis, 6,75% in moderate chronic periodontitis and in sites with advance chronic periodontitis was not isolated CSN, without difference among them (p = 0,672). There was no significant difference to presence and infection levels of CSN as related to host factors, local environm ent and traits of the diseases. Amongst the 74 samples of CSN isolated, the biggest resistance was observed to penicillin (55,4%), erythromycin (32,4%), tetracycline (12,16%) and clindamycin (9,4%). 5,3% of the isolates were resistant to oxacilin and methicillin. No resistance was observed to ciprofloxacin, rifampicin and vancomycin. It was concluded that staphylococci are found in low numbers in healthy or sick periodontal sites in a similar ratio. However, a trend was observed to a reduction in staphylococci occurrence toward more advanced stages of the disease. This low prevalence was not related to any variables analyzed. Susceptibility profile to antibiotics demonstrates a raised resistance to penicillin and a low one to methicillin. To erythromycin, tetracycline and clindamycin was observed a significant resistanceMaster Thesis Avaliação clínica longitudinal do periodonto de dentes pilares e não pilares de próteses parciais removíveis(Universidade Federal do Rio Grande do Norte, 2007-02-27) Amaral, Bruna Aguiar do; Carreiro, Adriana da Fonte Porto; ; http://lattes.cnpq.br/6618350120004415; ; http://lattes.cnpq.br/2949738370093349; Batista, André Ulisses Dantas; ; http://lattes.cnpq.br/9510942902249475; Seabra, Eduardo Gomes; ; http://lattes.cnpq.br/6218058757798526The literature has shown a relation between periodontics and the removable partial denture (RPD), with progressive destruction observed in the support structures. The aim of this study was to clinically assess periodontal condition in users of removal partial denture (RPD), and compare right abutments teeth, indirect abutments and controls before installation and after 1 year, in addition to comparing tooth-supported and tooth mucosa-supported abutments. A total of 50 patients, 32 women and 18 men, mean age of 45 years, took part in the study. The patients were examined by a single examiner at prosthesis installation and after 3, 6, 9 and 12 months. The following were verified at each examination: Probe Depth (PD), Plaque Index (PI), Gingival Index (GI), the amount of Keratinized Mucosa (KM), Gingival Recession (GR) and Dental Mobility (DM); in addition patients received oral hygiene orientation, accompanied by prophylaxis, periodontal scaling and root planing (PSRP), when necessary. Analysis of Variance (ANOVA) with Tukey-Kramer post test was used to assess the dependent variables (PD, PI, KM, GR) of the three groups over time while Friedman s test was used for GI. To assess the outcomes of prosthesis type in the right abutment group, a confidence interval-based analysis was performed. The results showed that the control group was the least compromised in all the variables studied. With respect to development of the groups over time, it was verified that the measures for GR, PD, GI and KM increased from initial examination to 1 year of use in all the groups, but only PI showed a significant increase. There was a non-discriminatory low prevalence of dental mobility. The tooth mucosa-supported prosthesis had significantly higher values for GR, GI and PI and significantly lower ones for KM when compared to tooth-supported. Over time, both types of prostheses showed no significant differences from initial to final examination for the variables GR, PD, KM and GI, with PI significant only for tooth-supported. The results showed that the teeth most involved in RPD design had greater potential of periodontal damage, probably because of greater dental biofilm accumulation. Abutments elements adjacent to the free extremities had less favorable periodontal condition than those adjacent to interpolated spaces, but the use of RPD did not worsen the initial conditionMaster Thesis Influência de fatores de risco na prevalência de hábitos bucais deletérios em crianças de 0 a 5 anos na cidade do Natal-RN(Universidade Federal do Rio Grande do Norte, 2007-03-28) Araújo, Iara Medeiros de; Oliveira, Angelo Giuseppe Roncalli da Costa; ; http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4794935P9&dataRevisao=null; ; http://lattes.cnpq.br/9433099370898116; Rabello, Patrícia Moreira; ; http://lattes.cnpq.br/0027481347497178; Costa, Iris do Céu Clara; ; http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4794938J9Literature has demonstrated to the narrow relation between deleterious habits and the occurrence of malocclusion in minors of 5 years. The existence of these habits, however, already considered as risk factors, having also, its determinative ones, which present cultural dimensions and economic social, many of them related to the parents of the child, having in account that such habits if develop in phases in which the child establish a narrow relation of dependence. This study it had an objective to investigate the prevalence of deleterious buccal habits in children and its relation with the economic social and characteristics of the parents. It was developed an epidemiologist study of transversal character with interview, through daily pay-tested form, with 218 parents in the day of the National Campaign of Vaccination. In the cast of the variable that had composed the study, they had been used, as changeable dependents, the use of the baby's bottle, bottle and the digital suction, being considered as outcomes of the research. Amongst the independent variable, the economic social factors (type of occupation, number of children, civil state, sort, schooling and age) and staffs of the parents (self perception in oral health) had entered as the variable to be analyzed in the problems of the infantile odontology. The collected data had been submitted to the analysis descriptive and inferential statistics, being used the test qui-square and the analysis of the possibility reasons. As main results, it was found that breast feeding before the six months if presents as one of the main factors of risk for the use of baby's bottle (p< 0.001, OR= 2.8, I.C= 1.589 4.906), bottle (p< 0.001, OR= 3.7, I.C.= 2.076 6.624) and digital suction (p< 0.014, OR= 3.5, I.C.= 1.225 10.181). From the data found, one concludes that breast-feeding is considered a primordial factor for not the installation of deleterious oral habits and that the economic social and cultural factors can reflect in central way in the performance of this act