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1

Simioni, Milena 1983. "Investigação da região 22q11.2 em defeitos de linha media facial com hipertelorismo." [s.n.], 2008. http://repositorio.unicamp.br/jspui/handle/REPOSIP/312229.

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Orientador: Vera Lucia Gil da Silva Lopes
Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas
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Resumo: Os Defeitos de Linha Média Facial com Hipertelorismo (DLMFH) constituem um grupo de anomalias craniofaciais raras e heterogêneas caracterizado por hipertelorismo ocular e fenda nasal mediana e (ou) lateral. Esses defeitos podem ocorrer isoladamente ou associados a dismorfismos com ou sem padrão definido, motivo pelo qual sua incidência não foi estabelecida até o momento. Dentre os fatores que podem participar da sua gênese encontra-se a perda de controle de genes de desenvolvimento envolvidos no processo de formação facial. A microdeleção 22q11.2, região dos genes HIRA/TUPLE1 e TBX1, causa a Síndrome Velocardiofacial e a Seqüência de DiGeorge. Essa deleção também foi descrita em casos esporádicos de anomalias congênitas múltiplas e DLMFH. Esses fatos, corroborados por extensa revisão da literatura, sugerem que os DLMFH possam fazer parte do espectro dessas condições clínicas e estarem associados a alterações na região 22q11.2. Para estudar essa hipótese, 10 indivíduos com DLMFH foram analisados por meio da técnica de FISH, utilizando a sonda comercial 22q11.2 DiGeorge ¿ HIRA/TUPLE1 locus (VysisTM). Não foi encontrada perda de fragmento cromossômico nessa região em nenhum dos indivíduos analisados. Os genes HIRA/TUPLE1 e TBX1 foram estudados por meio de técnicas moleculares. Não foi possível realizar a padronização da amplificação dos exons do gene HIRA/TUPLE1. Alterações de seqüência no gene TBX1, descritas como polimorfismos de nucleotídeo único e uma alteração inédita no exon 9C, 1132G ? A, foram encontradas. Em vista do tamanho amostral e da heterogeneidade clínica e etiológica, o presente trabalho não pode relacionar o envolvimento da região 22q11.2 na patogenia dos DLMFH
Abstract: Midline Facial Defects with Hipertelorism (MFDH) is a rare and heterogeneous group of craniofacial disorders characterized by ocular hypertelorism and bifid nose. This group of craniofacial defects occurs isolated or as part of a syndrome. For these reasons, its prevalence is still unknown. Alterations in developmental genes involved in facial process could be implicated in the genesis of this condition. The 22q11.2 microdeletion, localization of the HIRA/TUPLE1 and TBX1 genes, causes Velocardiofacial Syndrome and DiGeorge Syndrome. This deletion was also described in few cases of multiple congenital anomalies and MFDH. These facts suggested that some cases of MFDH may be part of the spectrum of these conditions and associated to alterations in the 22q11.2 region. In order to verify this hypothesis, fluorescent in situ hybridization (FISH) for 22q11.2 region (DiGeorge ¿ HIRA/TUPLE1 locus probe, VysisTM) was performed on metaphase chromosomes and nuclei of 10 individuals with MFDH. The 22q11.2 deletion was not found in any patient. Molecular techniques were applied in the study of HIRA/TUPLE1 and TBX1 genes. The amplification of HIRA/TUPLE1 exons was not possible to be realized. Alterations in the sequence of TBX1 gene, classified as single nucleotide polymorphism and a new alteration in exon 9C, 1132G ? A, were found. In view of the size of the sample and the clinical-genetic heterogeneity, we could not associate the involvement of 22q11.2 region in the genesis of MFDH
Mestrado
Ciencias Biomedicas
Mestre em Ciências Médicas
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2

Howe, Andrew M. "The role of vitamin K in craniofacial development." Thesis, The University of Sydney, 1997. http://hdl.handle.net/2123/4925.

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3

Jones, Melissa Taylor Watson. "Adult Discouragement: Parents of Children with Craniofacial Anomaly." Thesis, University of North Texas, 1996. https://digital.library.unt.edu/ark:/67531/metadc278310/.

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The Discouragement Scale for Adults (DSA) was developed to assess for the Adlerian construct of discouragement in adults age 18 years and over. Data were collected from three samples: norm (n=586), presumed discouraged (n=47), and parents of children with craniofacial anomaly (n=105). Five subscales corresponding to life tasks identified in Adlerian literature as work, love, society, self-significance, and spirituality underlie the 60 item DSA. Item selection was based on ratings by five notable Adlerians and item correlations with scale scores. Gender, age, and ethnicity norms were established for the norm, presumed discouraged, and craniofacial samples. Across three samples, no significant ethnic differences were found. Normative findings indicated females are less discouraged than males on the Total DSA, the society and spirituality subscales. Age findings indicated the 18-34 year old sample is more discouraged than other ages on the Total DSA, the work, society, and spirituality subscales. Presumed discouraged findings indicated females are less discouraged than males on the society subscale. Craniofacial findings indicated females are less discouraged on the society subscale, but more discouraged on the self-significance subscale than males. Age findings indicated the 18-34 year old sample is more discouraged than other ages on the self subscale. Research on CPA parents' relationship status, CPA child's birth order, parental role of adult to CFA child, length of time the parent has cared for CFA child, the CFA child's age, CFA parent's education level, and CFA child's craniofacial anomaly diagnosis was conducted. Findings indicated birthmothers are less discouraged than birthfathers on the society subscale, but more discouraged on the self-significance subscale. Internal consistency ratings of the DSA were .9392, .9496, and .9365 for three samples. Correlations to measures of social interest were negative and significant, reflecting an inverse relationship between discouragement and social interest. Factor analysis and interscale correlations are presented. Future research could include continued instrument validation and establishment of score ranges to indicate adult discouragement.
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4

Chan, Kui-ming, and 陳居明. "MT1-MMP in craniofacial development and FGF signaling." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2007. http://hub.hku.hk/bib/B40203645.

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5

Eley, Karen A. "Imaging the craniofacial skeleton : is MRI a viable alternative to ionising radiation?" Thesis, University of Oxford, 2012. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.711645.

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6

Sae-Pang, Jearn Jang, and 彭淦長. "Craniofacial abnormalities in transgenic mice with ectopic expression of the Hoxb-3 gene." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2002. http://hub.hku.hk/bib/B31227818.

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7

Cloonan, Yona Keich. "Sleep outcomes in children with craniofacial microsomia /." Thesis, Connect to this title online; UW restricted, 2007. http://hdl.handle.net/1773/10877.

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8

Naidoo, Sudeshi. "Fetal alcohol syndrome in the Western Cape : craniofacial and oral manifestations : a case control study." Thesis, Stellenbosch : Stellenbosch University, 2003. http://hdl.handle.net/10019.1/53425.

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Dissertation (PhD)--Stellenbosch University, 2003.
ENGLISH ABSTRACT: Introduction: Fetal alcohol syndrome (FAS) consists of multi-system abnormalities and is caused by the excessive intake of alcohol during pregnancy. The teratogenic effect of alcohol on the human fetus has now been established beyond reasonable doubt and FAS is the most important human teratogenic condition known today. The syndrome, first described by Lemoine in1968 in the French literature and in the English literature by Jones and Smith in 1973, has since been corroborated by numerous animal and human studies. This study has grown out of several epidemiological, prenatal and infant studies in areas of the Western Cape that are currently being undertaken by the Foundation for Alcohol Related Research (FARR). Preliminary data from studies in Wellington have confirmed that a significant proportion of school-entry children have FAS. The prevalence ofF AS in this community exceeds that for Down syndrome by a factor of30 times. The frequency ofFAS in high-risk populations of the Western Cape is the highest reported anywhere in the world. With this background, and the paucity of FAS literature related to dentistry, the aim of this study was to determine the craniofacial and oral manifestations ofF AS in a sample of school-going children in the Western Cape. Methodology: This study is a descriptive, case-control, cross-sectional study using a random cluster sampling method. On the day of examination, children were weighed, and their height and head circumference were measured. They then had photographs and radiographs taken, followed by an oral examination. For each child, the following information was recorded on the data capture sheet: date of birth, gender, head circumference, weight and height, enamel opacities, dental fluorosis, plaque index, gingival bleeding index, dentition status, oral mucosal lesions and dentofacial anomalies. Results: The total sample of90 children with diagnosed FAS and 90 controls, were matched for age, gender and social class. There were no significant age differences between the two groups (p=0.3363) and the mean ages were 8.9 and 9.1 for the FAS and control groups respectively. Head circumference (HC) differed significantly between the two groups (pAFRIKAANSE OPSOMMING: Fetale alkoholsindroom (FAS) bestaan uit multisisteem abnormaliteite en word veroorsaak deur oormatige inname van alkohol tydens swangerskap. Die teratogeniese uitwerking van alkoholop die menslike fetus word nie meer betwyfel nie en FAS is die belangrikste menslike teratogeniese toestand tans bekend. Die sindroom, soos aanvanklik deur Jones en Smith in 1973 beskryf, is sedertdien deur vele studies op mens en dier bevestig. Hierdie studie het gegroei uit vele epidemiologiese-, prenatale- en kleuterstudies in dele van die Weskaap wat tans onderneem word deur die Stigting vir Alkoholverwante Navorsing. Voorlopige data van die studies in Wellington bevestig dat 'n betekenisvolle deel van skoolbeginners FAS het. Die prevalensie van FAS in hierdie gemeenskap oortref dié van Down se sindroom met 'n faktor van 30. Die frekwensie van FAS in die Weskaap is die hoogste wat in die wêreld gerapporteer is. Met hierdie agtergrond, en die skaarste aan FAS literatuur wat op tandheelkunde betrekking het, was die doel van hierdie studie om die kraniofasiale en mondmanifestasies van fetale alkoholsindroom in 'n monster van skoolkinders in die Weskaap te ondersoek. Metodologie: Hierdie studie was 'n beskrywende, gevallebeheerde deursneestudie waarin 'n lukrake gebondelde monstermetode gebruik is. Op die dag van die ondersoek is die kinders geweeg en hulle lengte en kopomtrek bepaal. Hierna is foto's en x-straalopnames geneem, gevolg deur 'n mondondersoek. Die volgende inligting is vir elke kind aangeteken: geboortedatum, geslag, kopomtrek, massa en lengte, glasuur-opasiteite, tandfluorose, plaakindeks, gingivale bloedingsindeks, gebitstatus, mukosale letsels en dentofasiale anomalieë. Resultate: Die totale monster, bestaande uit 90 kinders met gediagnoseerde fetale alkoholsindroom en 90 bypassende kontroles, is vergelyk ten opsigte van ouderdom, geslag en sosiale klas. Daar was geen betekenisvolle ouderdomsverskille tussen die twee groepe nie (p- =0.3363). Kopomtrek het betekenisvol tussen die twee groepe verskil (p<0.0001), en die drie fotografiese diagnostiese afmetings is almal beïnvloed deur kopomtrek. Die prevalensie van glasuur-opasiteite tussen die FAS- en kontrolegroep was nie betekenisvol nie en het rondom 15% vir beide gewissel. Die opasiteite is hoofsaaklik gesien in maksillêre sentrale snytande en mandibulêre eerste molare. Meer as driekwart van beide groepe het plaak getoon, en byna tweederdes het gingivale bloeding met sondering gehad. Die gevallegroep het statisties betekenisvol meer (p
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9

Wong, Yee-man Elaine, and 王怡雯. "Analysis of abnormal craniofacial and ear development of a transgenic mutant with ectopic hoxb3 expression." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2006. http://hub.hku.hk/bib/B36875028.

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10

Aquino, Sibele Nascimento de 1984. "Avaliação de novos polimorfismos nos genes TGFB3, MSX1, MYH9 e JAG2 em pacientes com fissuras lábio-palatinas não-sindrômicas." [s.n.], 2011. http://repositorio.unicamp.br/jspui/handle/REPOSIP/289222.

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Orientador: Hercílio Martelli Júnior
Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba
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Resumo: Fissuras do lábio e/ou palato (FL/P) representam uma das anomalias congênitas mais comuns em humanos. A etiologia das FL/PNS é complexa e envolve a participação de inúmeros genes e fatores ambientais. Diversos estudos têm investigado genes relacionados a síndromes, que apresentam FL/P em seu espectro clínico, e/ou que são expressos durante o desenvolvimento do lábio e/ou palato. O objetivo deste estudo foi verificar se novos polimorfismos contidos nos genes relacionados ao desenvolvimento do lábio e palato, incluindo TGF?3, MSX1, MYH9 e JAG2, podem contribuir para a etiologia das FL/PNS. Seis regiões polimórficas foram genotipadas por PCR-RFLP (reação em cadeia da polimerase associada à análise de polimorfismo de fragmentos de restrição enzimática) em amostras de DNA proveniente de 367 pacientes com FL/PNS (grupo caso) e de 413 indivíduos não afetados (grupo controle). No grupo caso, 54% foram do gênero masculino e 46% do feminino, com idade média de 19,1 ± 14,9 anos e prevalência de indivíduos feodermas (42,5%) e leucodermas (42%). As fissuras lábio-palatinas (FLP) foram predominantes (54%), seguidas pela fissura labial (FL) (24%) e fissura palatina (FP) (22%). Do total de seis polimorfismos analisados neste estudo, apenas um foi confirmado nessa população: rs1057744 do gene JAG2. Para este locus polimórfico, o alelo A e o genótipo GA foi mais comum, no grupo controle e caso, não sendo encontrada diferença estatística significante. Para esse polimorfismo, a análise em um modo dominante ou recessivo também não mostrou diferenças estatísticas significantes. Assim, demonstrou-se que os polimorfismos rs34019007 e rs4252315, do gene TGF?3, rs62636562, do gene MSX1, rs11549910 e rs11549909, do gene MYH9 não foram confirmados. O polimorfismo rs1057744 do gene JAG2, embora confirmado, não apresentou associação significante com FL/PNS na população avaliada
Abstract: Cleft lip and/or cleft palate (CL/P) is one of the most common congenital anomaly in humans. NSCL/P etiology is complex and involves the participation of numerous genes and environmental factors. Several studies have investigated genes related to syndromes that have CL/P in their clinical and/or which are expressed during the development of lip and palate. The aim of this study was to determine whether polymorphisms contained genes related to the development of lip and/or palate, including TGF?3, MSX1, MYH9 and JAG2 can contribute to the etiology of NSCL/P. Six polymorphic regions were genotyped by PCR-RFLP (restriction fragment length polymorphism-polymerase chain reaction) in DNA samples from 367 patients affected by NSCL/P (experimental group) and 413 clinically normal subjects (control group). In the affected group, 54% were male and 46% female, mean age 19.1 ± 14.9 years and the prevalence of mixed black individuals (42.5%) and Caucasian (42%). The clefts of the lip with or without cleft palate (CLP) were predominant (54%), followed by cleft lip (FL) (24%) and cleft palate FP (22%). Out of 6 probable polymorphisms, only one was confirmed in this population: rs1057744 gene JAG2. For this polymorphic locus, the A allele and the genotype was slightly more common in the contr ol and experimental, without statistically signific ant differences. For this polymorphism , the analysis in a dominant or recessive mode also showed no statistically significant difference s between the group. This study demonstrated that the polymorphisms rs34019007 and rs4252315, present in the gene TGF?3, rs62636562, in the MSX1 gene, rs11549910 and rs11549909, in the MYH9 gene we re not confirmed. The rs1057744 polymorphism in JAG2 gene was confirmed in this study but not significantly associated with NSCL/P in the Brazilian population
Mestrado
Patologia
Mestre em Estomatopatologia
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Bandeen, Timothy C. "Effects of sickle cell disease on growth of the craniofacial complexes. /." View the abstract Download the full-text PDF version View the full-text HTML version, 2005. http://etd.utmem.edu/ABSTRACTS/2005%5F001%5Fbandeen%5Findex.html.

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Thesis (M.S.)--University of Tennessee Health Sciences Center, 2005.
Spine title: Effects of sickle cell disease on growth of the craniofacial complexes. Appendices: leaves 162-414 Bibliography: leaves 145-161.
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12

Perkiömäki, M. R. (Marja Riitta). "Craniofacial shape and dimensions as indicators of orofacial clefting and palatal form:a study on cleft lip and palate and Turner syndrome families." Doctoral thesis, University of Oulu, 2008. http://urn.fi/urn:isbn:9789514288708.

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Abstract The aim of this study was to define distinct craniofacial features in subjects with nonsyndromic cleft lip and palate (CLP) and in subjects with Turner syndrome (TS), and to evaluate the resemblance of these features among their family members. This might help in elucidating if there is a parental contribution to possible predisposing craniofacial features in cleft subjects and to the severity of certain distinct craniofacial features in subjects with X chromosome monosomy. The study population consisted of 29 Costa Rican CLP families including unaffected parents and siblings, and of 71 TS (45,X) subjects and members of their families. Based on lateral and frontal cephalometric analyses, cleft family members were characterized by reduced cranial height and head width, greater interorbital and nasal cavity widths, shorter anterior cranial base and palatal lengths, and shorter total face height compared to control values. With respect to these distinct craniofacial features, there were statistically significant associations in anterior cranial base and palatal length, and head, forehead and outer interorbital width measurements between parents and their children with CLP. The sidedness of the cleft in affected children was related to the asymmetry of the nasal cavity width in their parents. The distinct craniofacial features of the TS subjects, such as short clivus, retrognathic position of mandible, and narrow maxilla at the level of first premolars were related to their mothers' corresponding features. The presence of lateral palatine ridges, which were detected in one third of the TS subjects, was related to the narrowness of the posterior palate rather than to the variation in the tongue position. Distinct craniofacial features segregate in cleft family members. The several significant associations in distinct craniofacial dimensions between parents and children with CLP emphasize the importance of genetic factors in the genesis of nonsyndromic orofacial clefting. The present results support the concept that maternal factors contribute to the degree of deficiency in the growth of the cranial base and to the magnitude of mandibular retrognathism of their daughters with TS. Maternal influences may also modify the width of the palate in TS.
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Rodrigues, Rubens Matias. "Refinamento citogenético em indivíduos com anomalias craniofaciais sindômicas sem diagnóstico definido." Universidade de São Paulo, 2010. http://www.teses.usp.br/teses/disponiveis/61/61132/tde-17062010-141102/.

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Objetivos: Investigar possíveis alterações citogenéticas, através da técnica de bandamento de alta resolução, em indivíduos com anomalias craniofaciais associadas ao atraso no desenvolvimento neuropsicomotor e sem diagnóstico clínico-genético definido, com cariótipo (com bandas) prévio normal e estabelecer possível correlação entre o fenótipo dos indivíduos e as regiões cromossômicas alteradas. Local de execução: Laboratório de Citogenética Humana e Serviço de Genética Clínica, HRAC-USP, Bauru-SP. Indivíduos estudados e Resultados: O cariótipo de alta resolução de 16 indivíduos com anomalias craniofaciais associadas ao atraso no desenvolvimento neuropsicomotor pertencentes ao HRAC-USP, Bauru permitiu detectar alterações citogenéticas estruturais em 4 (25%) dos 16 indivíduos. Em 3 indivíduos detectou-se deleções em regiões subteloméricas (cromossomos 4p, 9p e 18q) e, em 1 indivíduo detectou-se adição de segmento cromossômico de origem desconhecida na região telomérica do cromossomo 12p. Conclusões: A frequência alta (25%) de alterações cromossômicas estruturais em regiões cromossômicas terminais (teloméricas e subteloméricas) mostra que a técnica de alta resolução é útil na identificação de alterações nessas regiões, portanto, indivíduos com anomalias craniofaciais e atraso mental, sem diagnóstico genético-clínico definido, cujo cariótipo convencional foi normal, devem ser, submetidos à análise dos cromossomos por meio do cariótipo de alta resolução antes do procedimento de CGHarray.
Objective: To investigate possible cytogenetic abnormalities through high resolution banding technique in individuals with craniofacial anomalies presenting previous normal karyotype, associated to neuropsychological development delay, without clinic-genetic diagnoses, and establish possible correlation between phenotype and possible candidate chromosomal regions. Local: Human Cytogenetic Laboratory and Clinical Genetic Service, HRAC-USP, Bauru, SP. Individuals and Results: High resolution karyotype of 16 individuals with craniofacial anomalies associated to neuropsychological development delay in follow-up at the HRAC-USP, Bauru allowed the detection of structural chromosomal abnormalities in 4 (25%) of them. Three individuals presented deletion in the subtelomeric region (chromosomes 4p, 9p, and 18q), and one individual presented an addition of an unknown chromosomal fragment in the telomeric region of chromosome 12p. Conclusions: The high frequency (25%) of structural chromosomal abnormalities in terminal region (telomeric and subtelomeric) shows that the high resolution technique is useful for identification of structural anomalies in these regions. Therefore, individuals with craniofacial anomalies associated to neuropsychological development delay without a definitive clinic-genetic diagnoses presenting a normal conventional karyotype, should be submitted to chromosomal analysis through high resolution karyotype before CGH-array procedure.
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Karsila-Tenovuo, Susanna. "The effect of anticancer therapy on craniofacial growth a macroscopic experimental and clinical study /." Turku : Turun Yliopisto, 2002. http://catalog.hathitrust.org/api/volumes/oclc/49899532.html.

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Fadl, Samer M. "Novel severity measurement of infant skull deformities." Yale University, 2009. http://ymtdl.med.yale.edu/theses/available/etd-05082009-125520/.

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Over the last decade, physicians have noted a rise in the prevalence of plagiocephaly. This sudden increase combined with the variability in presentation of infant head deformities makes the management of these cases often difficult. Currently, assessment for treatment is solely based largely on subjective determination of the severity of the patients skull malformation. Existing cephalometric techniques, such as external caliper measurements are commonly used, however these technique still contain inaccuracies, due to movement of an infant during measurement, soft tissue compression by the calipers, and lack of precise defined landmarks. (10) Given that no type of normalized measurement exists to identify objectively the severity of a patients skull deformity, the grading and selection of treatment modality has been relegated largely to experienced plastic surgeons and neurosurgeons. We report of a novel measurement that utilizes both CT scan and digital images combined with basic geometry to determine, objectively, the severity of an infants skull deformity, enabling all physicians to better decide what therapeutic intervention to employ.
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Bridgman, John B., and n/a. "Intercanthal and interpupillary distance in New Zealand Maori and Samoan populations." University of Otago. School of Dentistry, 1999. http://adt.otago.ac.nz./public/adt-NZDU20070524.122205.

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New Zealand Maori and Pacific Island ethnic groups are marking up an increasingly larger proportion of New Zealand�s population. Intercanthal distance (ICD) and management of congenital and acquired deformities of the craniofacial complex. The ICD and IPD have been found to differ to establish these measurements for New zealand Maori and Samoan populations. For New Zealand Maori males the mean ICD was 32.1mm with a standard deviation (SD) of 2.6mm, and the mean IPD was 63.3mm, SD 3.8mm. For New Zealand Maori females the mean ICD was 30.7mm, SD2.7mm and the mean IPD was 60.1mm, SD2.8mm. For Samoan males the mean ICD was 33.9mm, SD2.5mm and the mean IPD 64.5mm, SD3.5mm. For Samoan females the mean ICD was 32.9mm, SD2.3mm and their mean IPD was 61.7mm, SD2.8mm. Consistent with other ethnicities New Zealand Maori and Samoan males have wider values for ICD and IPD than females respectively. New Zealand Maori measurements tend to lie within the normal values established for Caucasian populations, whilst Samoans have larger values.
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Calderoni, Davi Reis 1982. "Avaliação do uso de placas sinterizadas de titânio com e sem recobrimento de beta-fosfato tricálcico no reparo de falhas ósseas em calvária de ratos = Evaluation of sintered titanium scaffolds with and without beta-tricalcium phosphate coating for calvarial defects repair in rats." [s.n.], 2014. http://repositorio.unicamp.br/jspui/handle/REPOSIP/312994.

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Orientadores: Paulo Kharmandayan, Ivan Felizardo Contrera Toro
Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: Introdução: A reparação de um defeito craniano é um procedimento desafiador, que requer não somente o preenchimento da falha óssea mas também estabilidade a longo prazo do material empregado e restabelecimento do contorno e simetria. Diversos tipos de materiais com diferentes características bem como diferentes métodos de produção dos implantes vêm sendo testados, sem que ainda haja um substituto ósseo considerado ideal. No presente estudo foram investigadas as propriedades de osteointegração de implantes da liga Ti6Al4V construídos por prototipagem com poros tridimensionalmente conectados considerando a influência do recobrimento dos mesmos com uma camada delgada de ?-fosfato tricálcico nestas propriedades. Método: Trinta ratos foram submetidos à criação de defeitos ósseos bilaterais na calvária, que foram preenchidos com implantes, recobertos ou não com ?-fosfato tricálcico, de modo aleatório. Os animais foram distribuídos em grupos e sacrificados 15, 45 e 90 dias após o procedimento. A integração dos implantes foi inicialmente avaliada por ensaio de compressão. A interface osso-implante foi analisada por meio de microscopia eletrônica de varredura. Resultados: A força máxima para produzir o deslocamento inicial dos implantes foi aumentando durante o período estudado, alcançando valores da ordem de 100N para ambos os tipos de implante. Foi observada integração entre o osso e a superfície dos implantes, com crescimento ósseo progressivo no interior dos poros. Não foram observadas diferenças significativas entre implantes recobertos e não recobertos por ?-fosfato tricálcico. Conclusão: Foi alcançada uma adequada osteointegração nas reconstruções cranianas utilizando implantes prototipados da liga Ti6Al4V com as características de porosidade e superfície descritas, sem influência do recobrimento cerâmico adotado. Os resultados sugerem que as características de construção utilizadas podem ser incorporadas aos implantes para reconstrução craniana para melhorar os resultados cirúrgicos
Abstract: Background: The repair of a calvarial defect is a challenging procedure, requiring not only filling of the bone gap but long term stability of the employed material and satisfactory contour and symmetry. Several types of materials with different characteristics have been studied, as well as various methods of implant production. However, to date no ideal bone substitute has been found. The osseointegration properties of porous prototyped implants with tridimensionally interconnected pores made of the Ti6Al4V alloy and the influence of a thin layer of calcium phosphate coating were investigated. Methods: Bilateral critical size calvarial defects were produced in thirty rats and filled with coated and uncoated implants in a randomized fashion. The animals were distributed in groups and kept for 15, 45 and 90 days before sacrifice. Implant mechanical integration to bone was evaluated with a push-out test. Bone-implant interface was analyzed using scanning electron microscopy. Results: The maximum force to produce initial displacement of the implants increased during the study period, reaching values around 100N for both types of implants. Intimate contact between bone and implant surface was present, with progressive bone growth into the pores. No significant differences were seen between coated and uncoated implants. Conclusion: Adequate osseointegration can be achieved in calvarial reconstructions using prototyped Ti6Al4V scaffolds with the described physical characteristics of surface and porosity. The results suggest that the proposed implant design characteristics can be incorporated into calvarial implants to improve reconstructive results.
Doutorado
Fisiopatologia Cirúrgica
Doutor em Ciências
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18

Portinho, Ciro Paz. "Cranioplastia com proteína morfogenética óssea, fosfato de cálcio, matriz dérmica acelular e alginato de cálcio : estudo experimental." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2014. http://hdl.handle.net/10183/104114.

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INTRODUÇÃO: As reconstruções ósseas craniofaciais utilizam enxertos ósseos rotineiramente. Entretanto, pode haver problemas na disponibilidade ou na cicatrização óssea. A engenharia tecidual visa a solucionar problemas como este, através da produção de órgãos e tecidos pela combinação entre matrizes, células e fatores de crescimento. OBJETIVO: O objetivo deste estudo foi avaliar cranioplastias experimentais, através da combinação entre proteína morfogenética óssea tipo 2 (BMP-2) e diferentes matrizes e carreadores. MÉTODO: Realizamos um estudo experimental prospectivo, comparativo e aberto, dividido em sete grupos: 1 – BT: BMP-2 e fosfato de cálcio (TCP); 2 – BM: BMP-2 e matriz dérmica acelular Matriderm ® (MDM); 3 – BA: BMP-2 e alginato de cálcio (ALG); 4 – TCP; 5 – MDM; 6 – ALG; 7 – Enxerto autógeno ou autoenxerto (AEN). Uma falha de 3 x 5 mm foi criada no osso parietal esquerdo de camundongos machos adultos, com mais de 3 meses. No mesmo tempo cirúrgico, uma das sete reconstruções foi realizada. Após cinco semanas, os animais for submetidos a eutanásia e um bloco ósseo, envolvendo a cranioplastia e uma margem de osso nativo circunjacente, foi retirado e preparado para análise histológica. Utilizamos o teste de Kruskal-Wallis para a análise estatística, com nível de significância de P<0,05. Os critérios histológicos utilizados foram: fusão de corticais; neoformação óssea; neovascularização e formação de medula óssea. RESULTADOS: Foram estudados 38 animais. Em todos os animais, houve permanência do material utilizado para reconstrução. Não houve retração cicatricial nem deiscência em nenhum dos casos. Uma incidência elevada de infecção ocorreu no grupo MDM (57%, P=0,037). Houve diferença estatística na maioria dos critérios avaliados. No critério fusão de corticais, os grupos AEN, TCP e BT obtiveram as melhores pontuações em relação aos demais (P=0,00846). No critério neoformação óssea, os grupos BT, AEN e TCP obtiveram as melhores pontuações (P=0,00835). Já no quesito neovascularização, os grupos melhor pontuados foram BM, BA, TCP e MDM em relação aos demais (P=0,001695). Por fim, no critério formação de medula óssea, o AEN liderou a pontuação, seguido dos grupos BT e TCP (P=0,008317). CONCLUSÕES: O uso de BMP-2 melhorou a regeneração óssea de cranioplastias experimentais, principalmente com a associação de TCP, que foi comparável ao AEN, o padrão-ouro, em alguns critérios histológicos. Ademais, a associação BM aumentou significativamente a neovascularização na área receptora e diminuiu a incidência de infecção em relação à MDM isolada.
INTRODUCTION: Bone craniofacial reconstructions employ bone grafts routinely. Nevertheless, there may be troubles either in availability or healing. Tissue engineering aims to solve such problems, building either organs or tissues through combination among matrices, cells and growth factors. OBJECTIVE: The aim of this study was to evaluate experimental cranial vault reconstructions, by combining bone morphogenetic protein type 2 (BMP-2) and different matrices or cell carriers. METHOD: We performed an experimental, open, prospective and comparative study, divided in seven groups: 1 – BT: BMP-2 and calcium phosphate (TCP); 2 – BM: BMP-2 and acellular dermal matrix Matriderm® (MDM); 3 – BA: BMP-2 and calcium alginate (ALG); 4 – TCP; 5 – MDM; 6 – ALG; 7 – Bone autograft (BAG). A bone failure, measuring approximately 3 x 5 mm was created in left parietal bone of adult male mice, aging more than 3 months old. At the same procedure, one of the seven reconstructions was performed. After five weeks, animals were sacrificed and a bone block, including cranial vault reconstruction area and nearby native bone was removed and processed to histological analysis. Statistics was made with Kruskal-Wallis test, and significance was considered when P<0.05. Histological criteria were: cortical fusion; new bone formation; neovascularization; and bone marrow formation. RESULTS: Thirty-eight animals were evaluated. In all of them, materials used to reconstruction remained at the receptor site. There has been neither dehiscence nor wound retraction in any case. A higher incidence of infection has occurred in MDM group (57%, P=0.037). There has been significant difference in most of the studied histological criteria. In cortical fusion, groups BAG, TCP, and BT have got the best scores, comparing to the others (P=0.00846). In new bone formation, groups BT, BAG, and TCP have presented the best scores (P=0.00835). When neovascularization was considered, best groups were BM, BA, TCP, and MDM (P=0.001695). At last, BAG group has been the best in bone marrow formation, followed by groups BT and TCP (P=0.008317). CONCLUSIONS: BMP-2 has increased bone regeneration in experimental skull reconstruction, especially when combined to TCP. Such association was even comparable to BAG, the gold-standard treatment, in some histological criteria. Besides, BM group has increased significantly neovascularization in receptor area and decreased the incidence of infection, when compared to MDM alone.
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19

Simpson, Ellie Kristina. "Variation in cranial base flexion and craniofacial morphology in modern humans." Title page, table of contents and abstract only, 2005. http://hdl.handle.net/2440/37790.

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Cranial base flexion has been used extensively as a baseline or standard from which to interpret differences in craniofacial growth and morphology. Lateral cephalometric radiographs of 414 adults representing seven samples from around the world were compared for variation in cranial base and facial morphology. The samples represent Australian Aboriginal, New Zealand Maori ( Polynesian ), Thai, Chinese, white American, African Sotho / Xhosa / Zulu and African Khoi / San populations. Seven angles of cranial base flexion, five craniofacial angles and nine cranial base and facial dimensions were measured on tracings of lateral cephalometric radiographs. Numerous significant correlations were found between cranial base flexion angles, craniofacial angles and dimensions of the cranial base and craniofacial skeleton. A positive correlation was found between the orientation of the foramen magnum, clivus and the anterior cranial base, with a negative correlation between these angles and the orientation of the hard palate. There was also a parallel relationship between the orientation of the foramen magnum and the anterior cranial base ( measured from pituitary point to nasion ). Cranial base flexion, craniofacial angles and dimensions differed significantly between some samples. Despite this, there was no evidence of distinct facial types between samples. Multivariate statistics revealed some discrimination between some samples for dimensions ; however, if angles were used alone, less than 50 % of individuals could be correctly assigned to their sample of origin. Most of the variation could be attributed to variation between individuals, rather than variation between samples. The range of variation in cranial base flexion is considerable, and needs to be taken into account when comparing samples. Flexion of the cranial base is generally insufficient to distinguish people from different geographic samples. The functional and evolutionary significance of the relationship between the orientation of the foramen magnum and cranial base flexion is discussed for its potential usefulness as a reference line for interpreting craniofacial morphology.
Thesis (Ph.D.)--Medical School and Dental School, 2005.
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20

Jämsä, Marjo. "Craniofacial morphology and cartilage in transgenic mice with mutations in the type II collagen gene." Turku : Turun Yliopisto, 2001. http://catalog.hathitrust.org/api/volumes/oclc/47834226.html.

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21

Simioni, Milena 1983. "Investigação de fatores genéticos na etiologia de fendas orofaciais típicas." [s.n.], 2008. http://repositorio.unicamp.br/jspui/handle/REPOSIP/309824.

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Orientador: Vera Lucia Gil da Silva Lopes
Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: As fendas orofaciais típicas (FOT) são defeitos congênitos prevalentes que possuem múltiplas etiologias. Estudos populacionais apontaram diferentes genes relacionados às FOTs. Entretanto, em muitos casos, a etiologia permanece desconhecida. A investigação individualizada, utilizando em conjunto diferentes ferramentas laboratoriais, é uma abordagem mais complexa que pode contribuir na caracterização etiológica das FOTs. Assim, este estudo teve como objetivo investigar os fatores genéticos envolvidos na etiologia das FOTs em uma casuística composta por 23 indivíduos afetados, incluindo casos sindrômicos e não-sindrômicos, familiais e esporádicos. Participaram do grupo controle 20 indivíduos sem história familial de fenda em três gerações. Todos os indivíduos portadores de FOT foram previamente avaliados por um médico geneticista e por exame de cariótipo em linfócitos, sendo dois casos detectados com aberrações cromossômicas. A análise de alterações no número de cópias de segmentos de DNA (Copy Number Variation, CNVs) por hibridação genômica em arrays (aGH), baseada na comparação com grupo controle, apontou um novo gene de candidato para FOT, o gene TCEB3, e identificou uma duplicação no gene FGFR1. Em um paciente com fenda palatal submucosa e quadro sindrômico, a utilização da técnica de aGH, em conjunto à hibridação in situ fluorescente (FISH) e Multiplex Ligationdependent Probe Amplification (MLPA), possibilitou a caracterização da aberração cromossômica detectada pelo cariótipo. Em todos os portadores de FOT também foi realizado sequenciamento direto dos genes IRF6, FOXE1, GLI2, MSX2, SKI, SATB2, SPRY1, MSX1, FGF8, FGFR1; em um paciente específico, foi avaliado o gene P63. Alterações de sequencia inéditas foram encontradas nos genes FOXE1, MSX1, GLI2 e FGF8, assim como uma inserção no gene P63, cujos efeitos na proteína codificada deverão ser confirmados em estudos futuros. Os resultados deste trabalho exemplificam a diversidade de fatores genéticos envolvidos na etiologia das FOTs e o desenho de estudo utilizado mostrou a eficácia do uso concomitante de diferentes abordagens investigativas neste grupo de defeitos congênitos
Abstract: Typical oral cleft (TOC) is a prevalent and heterogeneous group of congenital defects with multiple etiologies, which remain unknown in several cases. Population studies detected several genes related to TOC. An individualized investigation, involving different laboratorial tools at same time, is an approach that can contribute on the etiological characterization of the TOC. The aim of this study was to investigate genetic factors involved on TOC in a sample composed by 23 individuals (syndromic and non-syndromic; familial and sporadic cases). The control group included 20 individuals without TOC in three generations. All patients were previously evaluated by clinical geneticists and performed karyotype test that showed chromosomal aberrations in two cases. Copy number variation (CNV) investigation by genomic hibridization in arrays (aGH), based in a comparative to control group data, detected a new candidate gene to TOC (TCEB3), and identified a duplication affecting FGFR1 gene. In one patient with syndromic form of submucous cleft palate, the use of aGH technique, together with Fluorescent in situ hibridization (FISH) and Multiplex ligation-dependent probe amplification (MLPA), characterized the chromosomal aberration previously detected by karyotype. Direct sequencing of IRF6, FOXE1, GLI2, MSX2, SKI, SATB2, SPRY1, MSX1, FGF8 and FGFR1 genes was performed in all individuals; in a specific case, P63 gene was investigated. New sequence alterations were found in FOXE1, MSX1, GLI2 e FGF8 genes, as well as an insertion in P63 gene, which effects will be verified in futures studies. In conclusion, results here described reflect the diversity of genetic factors involved in the etiology of TOC and the type of study show the efficiency of the use of different techniques in the etiological investigation of this congenital defect
Doutorado
Ciencias Biomedicas
Doutor em Ciências Médicas
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22

Basso, Rafael de Campos Ferreira 1974. "Uso de sacaffolds de Poli L Lactide e de Poli L Lactide com hidroxiapatita em calota craniana : modelo experimental em ratos Wistar." [s.n.], 2014. http://repositorio.unicamp.br/jspui/handle/REPOSIP/312993.

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Orientador: Paulo Kharmandayan
Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: O tratamento de deformidades no corpo humano, principalmente deformidades ósseas craniofaciais, sejam elas causadas por trauma, infecções, deformidades congênitas ou pós exerese tumorais, continua sendo, nos dias atuais, um grande desafio ao cirurgião. Sabe-se que os enxertos de tecidos autólogos são o padrão ouro para essas reparações, porém, é notável a escassez de áreas doadoras. Nos últimos anos, com o avanço da engenharia de tecidos usando cultura de células semeadas em implantes, tem aumentado vertiginosamente a procura por polímeros biorreabsorvíveis que possam ser considerados ideais para fabricação de moldes, conhecidos cientificamente como scaffolds, carreadores de células capazes de recompor defeitos causados por perdas teciduais. O presente experimento objetiva estudar, experimentalmente, o uso de placas de Poli L Lactide (PLLA) e Poli L Lactide associada à Hidroxiapatita (PLLA + HA), obtidas por rotofiação (rotary jet spinning), como uma possibilidade de oferecer scaffolds de boa qualidade para colaborar com o avanço da engenharia tecidual. Para isso, utilizou-se 30 ratas da raça Wistar, distribuídas em 3 grupos,nas quais foram realizados defeitos críticos na calota craniana. Em seguida foram implantados scaffolds de PLLA e PLLA + HA e comparados com o grupo controle, que não recebeu implante. Os resultados mostraram que nos casos em que apenas foram realizados os defeitos nas calotas cranianas, não ocorreram a cicatrização óssea. Nos casos em que os scaffolds de PLLA e de PLLA + HA foram usados, notou-se rica neovascularização, acompanhada de reação do tipo corpo estranho e presença de osso reativo ao redor dos implantes
Abstract: The treatment of deformities in the human body, especially craniofacial bone deformities, whether caused by trauma, infection, congenital or due to resection tumors, remains, nowadays, a great challenge to the surgeon. It is known that autologous tissue grafts is the gold standard for these repairs, however, it is remarkable the scarcity of donor areas. During the last years, with the improvement of tissue engineering using cell culture growth in implants, has increased dramatically the search for an ideal polymer that can be used as a mold, known as scaffolds, for cell attachment and thus enabling the recomposition of defects caused by tissue loss. The present experiment aims to study experimentally the use of Poly L-Lactide(PLLA) plates and Poly L-Lactide(PLLA) associated with Hydroxyapatite (HA), obtained by Rotary Jet spinning, as a possibility to provide scaffolds with good quality and affordable costs to collaborate with the tissue engineering advancement. For this, were used 30 Wistar rats, distributed into 3 groups, in which critical defects were performed in the skull. Then scaffolds of PLLA and PLLA + HA (groups 2 and 3) were implanted and compared with the control group that didn¿t receive implant (group 1). The results have shown that in cases where only the defects in cranial caps were done, bone healing have not occurred. In cases where the scaffolds of PLLA and PLLA+ HA were used, rich neovascularization was noted, accompanied by foreign body type reaction and presence of reactive bone around the implants
Mestrado
Fisiopatologia Cirúrgica
Mestre em Ciências
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23

Dalben, Gisele da Silva. "Disgenesias dentárias, alterações de tecido mole e morfologia craniofacial em pacientes com síndrome velocardiofacial e síndrome G/BBB." Universidade de São Paulo, 2007. http://www.teses.usp.br/teses/disponiveis/25/25136/tde-09112007-105451/.

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Este estudo investigou a prevalência de disgenesias dentárias, alterações de tecido mole e características cefalométricas em pacientes com síndrome velocardiofacial e síndrome G/BBB. A presença de disgenesias dentárias foi avaliada em pacientes acima de seis anos de idade; para a análise cefalométrica, foram avaliadas telerradiografias laterais obtidas antes de qualquer intervenção ortodôntica. A amostra de estudo para a síndrome velocardiofacial incluiu 26 pacientes para análise de disgenesias dentárias e alterações de tecido mole e 18 pacientes para análise cefalométrica. Para a síndrome G/BBB, foram analisados 21 pacientes quanto à presença de disgenesias dentárias e alterações de tecido mole, e 23 pacientes para a análise cefalométrica. Foram incluídos apenas pacientes de etnia branca. A ocorrência de agenesias dentárias e dentes supranumerários foi comparada a pacientes sem nenhuma alteração morfofuncional, pareados para gênero e idade. Para a análise cefalométrica, as telerradiografias foram traçadas manualmente; os traçados foram digitalizados e as variáveis foram medidas com auxílio do software Dentofacial Planner 7.0. Nesta análise, os pacientes também foram comparados a pacientes sem nenhuma alteração morfofuncional, pareados para gênero e idade. Para a síndrome velocardiofacial, 76,92% dos pacientes apresentaram pelo menos uma disgenesia dentária, com predominância de alterações hipoplasiantes, principalmente representadas por hipodesenvolvimento da cúspide lingual do primeiro pré-molar inferior e opacidades de esmalte; a ocorrência de agenesias dentárias e dentes supranumerários foi semelhante à observada no grupo controle. Na análise cefalométrica, observou-se menor comprimento da base do crânio (total e da parte posterior); retrusão e redução da altura posterior da maxila; aumento do ângulo goníaco; aumento do ângulo interincisal; maior inclinação lingual dos incisivos inferiores; redução do ângulo nasolabial; e redução da profundidade nasal, comparado ao grupo controle. Com relação à síndrome G/BBB, 95,23% dos pacientes apresentaram pelo menos uma disgenesia dentária, com predominância de alterações hipoplasiantes; a freqüência de agenesias dentárias e dentes supranumerários foi significativamente maior comparada ao grupo controle. Foi observada anquiloglossia em 11 de 21 pacientes. A análise cefalométrica revelou aumento do ângulo da base do crânio; maior retrusão dos ossos nasais; encurtamento do ramo, redução do comprimento, e retrusão da mandíbula; maior discrepância maxilomandibular, com maior convexidade facial; maior inclinação lingual dos incisivos inferiores e superiores; padrão de crescimento mais vertical; nariz mais achatado, ponte nasal mais curta, maior retrusão nasal e redução da profundidade nasal, comparado ao grupo controle. Em conclusão, na avaliação de pacientes com hipótese diagnóstica das referidas síndromes, sugere-se investigar a anatomia oclusal de pré-molares inferiores no caso da síndrome velocardiofacial, e a presença de dentes supranumerários anteriores inferiores e anquiloglossia para a síndrome G/BBB. A análise cefalométrica também indicou diferenças significativas em diversas variáveis, simultaneamente servindo como parâmetro na descrição das síndromes e exigindo protocolo de tratamento diferenciado para estes pacientes.
This study investigated the prevalence of tooth abnormalities, soft tissue changes and cephalometric analysis in patients with velocardiofacial syndrome and G/BBB syndrome. The presence of tooth abnormalities was evaluated in patients older than six years; cephalometric analysis was conducted on lateral cephalograms obtained before any orthodontic intervention. The study sample for the velocardiofacial syndrome included 26 patients for analysis of tooth abnormalities and soft tissue changes, and 18 patients for cephalometric analysis. For the G/BBB syndrome, 21 patients were analyzed as to the presence of tooth abnormalities and soft tissue changes, and 23 patients for cephalometric analysis. Only white patients were included. The occurrence of tooth abnormalities and supernumerary teeth was compared to patients without any morphofunctional alterations, matched for gender and age. For cephalometric analysis, the lateral cephalograms were manually traced; tracings were digitized and the variables were measured on the software Dentofacial Planner 7.0. For this analysis, patients were also compared to individuals without malformations, matched for gender and age. For the velocardiofacial syndrome, 76.92% of patients presented at least one tooth abnormality, with predominance of hypoplastic alterations, especially represented by hypodevelopment of the lingual cusp of mandibular first premolars and enamel opacities; the occurrence of tooth agenesis and supernumerary teeth was similar to that observed in the control group. Cephalometric analysis revealed reduced length of the skull base (total and of the posterior portion); retrusion and reduction of posterior height of the maxilla; increased gonial angle; increased interincisal angle; greater lingual inclination of mandibular incisors; reduced nasolabial angle; and reduced nasal depth, compared to the control group. Concerning the G/BBB syndrome, 95.23% of patients presented at least one tooth abnormality, with predominance of hypoplastic alterations; the frequency of tooth agenesis and supernumerary teeth was significantly higher compared to the control group. Ankyloglossia was observed in 11 of 21 patients. Cephalometric analysis revealed increased cranial base angle; greater retrusion of nasal bones; shortening of mandibular ramus, reduced mandibular length, and mandibular retrusion; greater maxillomandibular discrepancy, with greater facial convexity; greater lingual inclination of maxillary and mandibular incisors; more vertical growth pattern; more flattened nose, shorter nasal bridge, greater nasal retrusion and reduced nasal depth, compared to the control group. In conclusion, during evaluation of patients with suspected diagnosis of the syndromes, investigation of the occlusal anatomy of mandibular premolars in case of velocardiofacial syndrome, and of the presence of mandibular anterior supernumerary teeth and ankyloglossia for the G/BBB syndrome are suggested. Cephalometric analysis also indicated significant differences in several variables, simultaneously serving as parameter for description of syndromes and requiring a customized treatment protocol for these patients.
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24

Carvalho, Luciana Alves de Souza. "Habilidades funcionais de autocuidado, mobilidade e função social em crianças com fissura labiopalatina e Espectro Óculo-Aurículo-Vertebral (EOAV)." Universidade de São Paulo, 2016. http://www.teses.usp.br/teses/disponiveis/25/25143/tde-28062016-080754/.

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As anomalias craniofaciais ocasionam comprometimentos estéticos e funcionais com grande impacto na saúde e na integração social da criança, com interferência no desenvolvimento global e social. Das anomalias craniofaciais este estudo abordou as Fissuras Labiopalatinas (FLP) e o Espectro Óculo Aurículo Vertebral (EOAV). As FLP constituem malformações resultantes de falta do fechamento completo dos tecidos que compõe o lábio e o palato. O EOAV, também conhecido como Síndrome de Goldenhar, é uma anomalia congênita de etiologia desconhecida, com manifestação genética variável e de causa bastante heterogênea. Conhecer as habilidades funcionais e o impacto destas no desenvolvimento global de crianças com EOAV e FLP pode otimizar o desenvolvimento de programas de prevenção e intervenção para promover a saúde e a integração social destes indivíduos. Este estudo foi delineado com objetivo de verificar e comparar o desempenho em habilidades funcionais quanto ao desempenho nas áreas de autocuidado, mobilidade, função social e nível de independência entre crianças com EOAV, crianças com FLP e um grupo comparativo, de crianças sem anomalias. O modelo de pesquisa foi observacional descritivo transversal com uma casuística de 39 pais/responsáveis de crianças na faixa etária entre três anos e sete anos e seis meses, de ambos os gêneros. Foram convidados para participar pais/responsáveis de crianças em tratamento no Hospital de Reabilitação de Anomalias Craniofaciais da Universidade e São Paulo (HRAC-USP) os quais foram divididos em três grupos: dois experimentais e um grupo comparativo. O instrumento para coleta dos dados das habilidades funcionais foi o Pediatric Evaluation of Disability Inventory (PEDI), em sua versão adaptada para o português. A avaliação é realizada por meio de entrevista com o cuidador, o qual deve saber informar sobre o desempenho da criança em atividades e tarefas típicas da rotina diária. Os dados foram apresentados por análise descritiva com medidas de tendência central (média aritmética), dispersão (desvio-padrão) e distribuição de frequência, nas variáveis: idades, gênero e nível socioeconômico da família e caracterização da casuística. Para as análises das pontuações bruta e normativa do questionário PEDI no que se refere às habilidades funcionais e a assistência do cuidador nas três áreas de função autocuidado, mobilidade e função social, foi utilizado o teste de variância One Way, e para o teste de normalidade foi utilizado Shapiro Wilk para variável dependente. A análise comparativa foi realizada pelo teste de Kruskal-Wallis, adotando-se o valor de significância de p< 0,05. Os resultados deste estudo na análise comparativa nas habilidades funcionais na mobilidade, houve diferença estatisticamente significante na comparação entre os grupos GC vs GEEOAV, no escore bruto, e entre os grupos GC vs GEEOAV e GC vs GEFLP, no escore normativo.Na assistência do cuidador no autocuidado, houve diferença estatisticamente significante na comparação entre os grupos GC vs GEEOAV, no escore normativo. Na assistência do cuidador na mobilidade, houve diferença estatisticamente significante na comparação entre os grupos GC vs GEEOAV nos escores bruto e normativo.Na assistência do cuidador na função social houve diferença estatisticamente significante na comparação entre os grupos GC vs GEFLP.
Craniofacial anomalies cause aesthetic and functional impairments with major impact on health and social integration of children with interference in global and social development. Craniofacial anomalies of this study addressed the cleft lip and palate (CLP) and the Spectrum goggles Atrium Vertebral (OAVS). The FLP constitute defects resulting from lack of complete closure of the tissues that make up the lip and the palate. The OAVS, also known as Goldenhar syndrome is a congenital anomaly of unknown etiology, with genetic variable manifestation and cause very heterogeneous. Knowing the functional abilities and their impact on the overall development of children with OAVS and FLP can optimize the development of prevention and intervention programs to promote health and social integration of individuals. This study was designed in order to verify and compare the performance of functional skills in performance in the areas of self-care, mobility, social function and level of independence among children OAVS, children with CLP and a comparison group of children without defects. The research model was crosssectional observational with a sample of 39 parents / guardians of children aged between three and seven years and six months, of both genders. Were invited to attend parent / guardians of children undergoing treatment at the Craniofacial Anomalies Rehabilitation Hospital of the University and São Paulo (HRAC-USP) were divided into three groups: two experimental and comparison group. The instrument for data collection of functional abilities was the Pediatric Evaluation of Disability Inventory (PEDI), in its version adapted to Portuguese. The evaluation is carried out through interviews with the caregiver, which should know to report on the performance of the child in typical activities and tasks of daily routine. The data were presented by descriptive analysis with measures of central tendency (arithmetic mean), dispersion (standard deviation) and frequency distribution, the variables: age, gender and socioeconomic status of the family and characterization of the series. For the analysis of raw scores and rules of ask questionnaire with regard to the functional skills and caregiver assistance in three areas of self-care function, mobility and social function, One Way variance test was used, and the normality test Shapiro Wilk was used for dependent variable. The comparative analysis was performed using the Kruskal-Wallis test, adopting the significance p value <0.05. The results of this study in comparative analysis on functional mobility skills, there was a statistically significant difference when comparing the GC vs GEEOAV groups in the raw score, and between the GC and GC vs vs GEEOAV GEFLP groups in normativo.Na score caregiver assistance self-care, there was a statistically significant difference when comparing the GC vs GEEOAV groups, the score normativo.Na caregiver assistance in mobility, there was a statistically significant difference when comparing the GC vs GEEOAV groups in the raw scores and normativo.Na caregiver assistance social function was no statistically significant difference when comparing the GC vs GEFLP groups.
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Antunes, Rodrigo Badotti. "Avaliação do volume orbitário nos avanços frontofaciais." Universidade de São Paulo, 2014. http://www.teses.usp.br/teses/disponiveis/5/5132/tde-27022015-095543/.

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Craniofaciossinostose sindrômica (CS) é uma desordem congênita associada às mutações dos genes FGFR1, FGFR2 e FGFR3. Ocasiona uma fusão prematura das suturas craniofaciais, levando à deficiência no crescimento do crânio e terço médio da face. A severidade dos sintomas relacionados à hipertensão intracraniana, aparelho respiratório (síndrome da hipopneia-apneia do sono) e ocular (órbitas rasas, proptose ocular, exorbitismo e falta de proteção do globo ocular), são parâmetros para indicar o procedimento cirúrgico. A tomografia-3D é uma opção atual e pouco utilizada para avaliar os volumes orbitais e a magnitude dos avanços craniofaciais e seus vetores; esse método permite melhor definição das estruturas anatômicas sem distorção das imagens, promovendo uma avaliação adequada dos resultados. Os objetivos do presente estudo foram avaliar os volumes orbitais, os avanços craniofaciais e seus vetores nas osteotomias Le Fort III e Monobloco com uso de aparelhos distratores, a correlação entre os avanços craniofaciais e a variação dos volumes orbitais e determinar a eficácia dos avanços craniofaciais por meio da comparação com índices normais de volumes orbitais. No período de janeiro de 2001 a dezembro de 2012, foram selecionados 20 pacientes submetidos ao alongamento ósseo gradual do terço médio da face, divididos em dois grupos. Grupo LF (n = 9), submetidos à osteotomia Le Fort III e Grupo MB (n = 11), submetidos à osteotomia frontofacial monobloco. A avaliação constou da revisão de prontuários e exames tomográficos, em que foram mensurados o volume orbital pela segmentação de imagens no programa InVesalius e modelagem 3D no programa Magics, e a magnitude dos avanços craniofaciais, e seus vetores, foram medidos no programa Rhinoceros. Os resultados foram submetidos à análise estatística: teste t- Student e ANOVA. No Grupo MB, houve aumento de 8,94 mm3 e 9,84 mm3 para a variação do volume orbital, nas órbitas direita e esquerda, respectivamente; no Grupo LF: 5,70 mm3 e 5,77 mm3, respectivamente, para esses parâmetros. A resultante do avanço médio, para a órbita direita e esquerda no Grupo LF foi 11,36 ± 3,80 mm e 11,11 ± 3,45 mm, respectivamente; já no Grupo MB, foi 14,22 ± 4,12 mm e 14,48 ± 4,49 mm, respectivamente. A correlação entre a resultante do avanço e a variação dos volumes orbitais foi significante no Grupo LF e para a órbita esquerda no Grupo MB. Em conclusão, o procedimento cirúrgico foi eficaz, tanto para o Grupo LF como para o Grupo MB, pois, houve aumento estatisticamente significativo do volume orbital no período pós-operatório; não houve diferença estatisticamente significativa, na avaliação da simetria, entre os volumes orbitais pós-operatórios, direito e esquerdo. Ainda, não houve diferença estatisticamente significante entre os volumes orbitais pósoperatórios quando comparados aos índices de normalidade
Syndromic craniofacial synostosis (CS) is a congenital disorder, which is most often, an autosomal dominant mutation associated to FGFR1, FGFR2 and FGFR3 genes. It causes a premature fusion of craniofacial sutures, leading to deficiency in skull growth and middle-third of the face. The severity of the intracranial hypertension related, respiratory syndrome (hypopneaapnea) and eye (shallow orbits, ocular proptosis, exorbitism and lack of protection of the eyeball) symptoms, are parameters that indicate the surgical procedure. Distraction osteogenesis of the middle-third of the face is currently the chosen technique for the treatment of patients with Craniofacial Synostosis syndrome candidates for the advancement of the middle-third of the face. The 3D-tomography is a current option and seldom used for this purpose; this method allows better definition of anatomical structures without image distortion, providing a more accurate assessment of the results. The objectives of the present study, were to assess quantitatively the craniofacial advancement and its vectors through 3D tomographic images, the osteotomy Le Fort III and Monobloc with use of distractor devices; Also, to evaluate the correlation between the craniofacial advances and the variation of orbital volumes and determine the effectiveness of craniofacial advances through the comparison with normal levels of orbital volumes. From January 2001 to December 2012, 20 patients underwent distraction osteogenesis of the middle-third of the face, divided into two groups. LF group (n = 9) underwent a Le Fort III osteotomy and MB group (n = 11) underwent a monobloc frontalfacial osteotomy. The evaluation consisted of the reviewing of the records and tomographic exams; measured is the orbital volume by image segmentation on the InVesalius software and 3D modeling on Magics software and the magnitude of facial advances, and their vectors, were measured on Rhinoceros software. The results were subject to statistical analysis: t-Student test and ANOVA. In the MB group, there was an increase of 8.94 mm3 and 9.84 mm3 for the variation of the orbital volume, the right and left orbits, respectively; in Group LF: 5.70 mm3 and 5.77 mm3 for these parameters. The resulting of average advance, for right and left orbit in Group LF was of 11.36 ± 3.80 mm, 11.11 ± 3.45mm, respectively; as for group MB it was 14.22 ± 4.12 mm and 14.48 ± 4.49 mm, respectively. Correlation between the results from the progress and the variation of orbital volume was significant in Group LF and left orbit in MB Group. In conclusion, the surgical procedure was effective for both the LF group as for the MB Group because: there was a statistically significant increase in orbital volume on the postoperative period; there was no statistically significant difference in the evaluation of symmetry between the postoperative period left and right orbital volumes. Still, there was no statistically significant difference between the postoperative orbital volumes when compared to normal ranges
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Tonello, Cristiano. "Avaliação por imagem tridimensional das características morfológicas e do crescimento do terço médio da face de pacientes com craniossinostose sindrômica submetidos ao avanço frontofacial em monobloco associado à distração osteogênica." Universidade de São Paulo, 2016. http://www.teses.usp.br/teses/disponiveis/5/5132/tde-07032017-151610/.

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INTRODUÇÃO: A osteotomia em monobloco para o avanço do terço médio e superior da face combinada ao alongamento ósseo gradual consiste em uma modalidade consagrada de tratamento das craniossinostoses sindrômicas. No entanto, alguns aspectos referentes à morfologia do terço médio facial dessas condições, seu comportamento durante o crescimento e quando submetido à cirurgia ainda são pouco compreendidos. OBJETIVOS: Avaliar, por meio de imagens tomográficas tridimensionais, um grupo de pacientes submetidos ao avanço frontofacial em monobloco associado à distração osteogênica, em idade de imaturidade esquelética, quanto às características morfológicas do terço médio da face, aos resultados obtidos com o avanço e seus efeitos no crescimento craniofacial comparados a um grupo não sindrômico. MÉTODOS: A amostra foi constituída de 25 indivíduos, em idade de dentição mista sendo: 16 submetidos ao avanço com exames de tomografia pré e pós-operatório e 9 de um grupo comparativo não sindrômico com exames de tomografia com 1 ano de intervalo durante o período de crescimento. Pontos de referência foram marcados nos modelos de superfície tridimensional do terço médio facial e as seguintes mensurações foram realizadas para o grupo comparativo, dos pacientes antes e após a cirurgia: determinação das dimensões da maxila, ângulos faciais e distâncias entre pontos na base do crânio e superfície da face. A mensuração das distâncias entre pontos correspondentes marcados nas imagens sobrepostas dos diferentes tempos foi utilizada para determinação da magnitude do avanço e comparada aos valores do grupo não sindrômico. Da mesma forma, o crescimento craniofacial prévio à cirurgia foi avaliado em 4 pacientes da amostra que dispunham de exames de tomografia com 1 ano de intervalo previamente ao avanço. O crescimento pós-operatório foi avaliado em 9 pacientes que tinham exames de tomografia com 1 ano de intervalo após o procedimento e ambos foram comparados com o crescimento observado no grupo não sindrômico. RESULTADOS: A maxila dos pacientes com craniossinostose é menor em largura e comprimento comparada aos não sindrômicos. Os ângulos faciais formados pelos pontos orbitário direito e esquerdo e ponto A, zigomático direito e esquerdo e ponto A são estatisticamente diferentes dos não sindrômicos. As distâncias do ponto Sela aos pontos do terço médio são menores nos pacientes comprometidos mas atingem valores comparáveis aos não sindrômicos após o avanço. O crescimento no grupo de crianças com craniossinostose embora não tenha apresentado valores estatisticamente diferentes dos demais, numericamente cresce menos que o grupo comparativo tanto prévia como posteriormente ao procedimento. CONCLUSÕES: O terço médio facial nas craniossinostoses apresenta configuração anatômica alterada, a maxila é hipoplásica e os ângulos faciais mais obtusos denotam uma menor projeção da porção central em relação às laterais. O avanço permite a normalização da posição, no entanto não muda a configuração alterada do terço médio. O crescimento aparentemente está comprometido independente do procedimento cirúrgico
INTRODUCTION: The monobloc osteotomy combined with gradual bone lengthening to advance the upper and midface is an established treatment modality of syndromic craniosynostosis. However, some aspects related to midface morphology and changes during growth and following surgery are still poorly understood. OBJECTIVES: Three-dimensional tomographic image evaluation of patients undergoing frontofacial monobloc distraction group in immature skeletal age is the objective of the study. The morphological characteristics of the midface, the results obtained with the advancement and its effects on craniofacial growth compared to a nonsyndromic group were evaluated. METHODS: The sample consisted of 25 patients of mixed dentition age: 16 submitted to advancement with pre- and postsurgery CT scans and 9 of a comparison nonsyndromic group with CT scans at 1-year intervals during craniofacial growth. Reference points were placed in the 3-dimensional surface models of the midface, and the measurements were performed to compare patients in the pre- and postsurgery groups: determination of the maxillary dimensions, facial angles, and distances between points on the skull base and the surface of the face. The measurement of distances between homologous points placed in the 3D superimposition of images from different times was used to determine the magnitude of the advancement and compared to the values of the nonsyndromic group. Presurgical growth was evaluated in 4 patients that had a 1-year interval prior to the surgery CT scans. Postsurgical growth was evaluated in 9 patients who had CT scans at 1-year intervals after the procedure, and they were compared with the growth of the nonsyndromic group. RESULTS: The maxillary width and length of syndromic patients are smaller compared to the nonsyndromic group. Facial angles formed by right and left orbital points and point A and the right and left zygomatic and Point A are statistically different from those in the nonsyndromic group. The distances from the point Sela to the midface points are lower in syndromic patients but reach values comparable to the nonsyndromic group after advancement. However, growth in the group of children with craniosynostosis did not yield statistically different values of others; it is smaller than the comparison group. CONCLUSION: The midface of syndromic craniosynostosis has a changed anatomical shape, the maxilla is hypoplastic, and the most obtuse facial angles denote a lower projection of the central portion relative to the lateral. The advancement allows the normalization of the position, but the midface shape is not changed.The growth apparently is affected independently of the surgical procedure
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Finck, Nathalia Silveira. "Características craniofaciais, posturais, articulares e respiratórias e sintomas de distúrbios respiratórios do sono em escolares na faixa etária de 7 a 14 anos." Universidade Federal do Espírito Santo, 2013. http://repositorio.ufes.br/handle/10/5869.

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O objetivo dessa dissertação foi investigar as alterações temporomandibulares, craniofaciais e posturais associadas à respiração bucal, além de avaliar a relação entre sinais clínicos e sintomas de distúrbios respiratórios do sono (DRS) em escolares respiradores bucais, na faixa etária de 7 a 14 anos. Trata-se de um estudo caso-controle, com amostra de 147 escolares, sendo 73 com respiração bucal (RB) e 74 com respiração nasal (RN), avaliados através de anamnese, exame clínico e testes respiratórios. Os escolares diagnosticados como respiradores bucais responderam a um questionário sobre a autopercepção de sintomas de DRS na infância, com foco em problemas do sistema mastigatório, nasais e do sono. A presença de respiração bucal foi estatisticamente significativa para as seguintes alterações: ausência de selamento labial (OR= 29.70); desvio durante abertura da boca (OR= 24.63); palato atrésico (OR= 5.07); assimetria facial (OR= 5.06); índice de Mallampati III e IV (OR= 2.85); má oclusão Classe II (OR=2.67); hipertrofia de conchas nasais (OR= 2.19). Não houve diferença significativa entre os grupos para as alterações posturais. Nos escolares RB, problemas na ATM e acordar com dor de cabeça foram associados à má oclusão Classe II e à falta de selamento labial. Dor na nuca e torcicolo foram associados à sobremordida alterada e à anteriorização da cabeça. Problemas com o sono, sonolência diurna, acordar à noite, roncar e dormir de boca aberta foram associados à hipertrofia das tonsilas palatinas e ao índice de Mallampati obstrutivo. A chance de alterações temporomandibulares e craniofaciais ocorrerem em escolares com padrão de respiração bucal foi elevada. O aparecimento de sintomas de DRS na infância parece estar associado à persistência da respiração bucal e suas consequentes alterações craniofaciais, oclusais, posturais e nas vias aéreas superiores
The aim of this study was to investigate the temporomandibular, craniofacial and postural changes associated with mouth breathing and also evaluate the relationship between clinical signs and SDB symptoms in children 7 to 14 years of age. A case-control study with a sample of 147 children, 73 mouth breathers (MB) and 74 nasal breathers (NB), were evaluated by anamnesis, clinical examination and respiratory tests. The schoolchildren diagnosed as MB answered a questionnaire on self-perceived symptoms of SDB, focusing on the masticatory system, nasal and sleep problems. The presence of mouth breathing was statistically significant with the following changes: a lack of lip seal (OR=29.70), a deviation during the opening of the mouth (OR=24.63), an atresic palate (OR=5.07), a facial asymmetry (OR=5.06), an obstructive Mallampati scores (OR=2.85), a Class II malocclusion (OR=2.67) and a turbinate hypertrophy (OR=2.19). No significant difference in postural pattern was found between groups. In the MB group, TMJ problems and wake up with headache were associated with a Class II malocclusion and a lack of lip seal. Stiff neck or neck pain were associated with an altered overbite and a forward head position. Sleep problems, daytime sleepiness, waking at night, snoring and sleeping with the mouth open were associated with a tonsillar hypertrophy and obstructive Mallampati scores. The chances of occurrence of temporomandibular and craniofacial changes were high in the MB schoolchildren. The emergence of the SDB symptoms in childhood appears to be associated with the persistency of the mouth breathing and their consequent craniofacial, occlusal, postural and upper airway s abnormalities
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Li, Lin. "Characterization of the TCOF1 Gene Using a Neuroblastoma Cell Line and a Mouse Model." Abstract, 24-page preview and downloadable full-text (PDF format) available to VCU users at:, 2006. http://proquest.umi.com/pqdweb?index=0&did=1192182461&SrchMode=1&sid=2&Fmt=2&VInst=PROD&VType=PQD&RQT=309&VName=PQD&TS=1179415484&clientId=4305.

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29

Goldenberg, Dov Charles. ""Estudo das alterações esqueléticas da região maxilar em pacientes submetidos à expansão rápida da maxila assistida cirurgicamente avaliadas por tomografia computadorizada"." Universidade de São Paulo, 2006. http://www.teses.usp.br/teses/disponiveis/5/5158/tde-04102006-151756/.

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A expansão rápida da maxila assistida cirurgicamente (ERMAC) é o procedimento de eleição para o tratamento da deficiência transversa de maxila em pacientes esqueleticamente maduros. Controvérsias em relação ao procedimento ainda persistem principalmente relacionadas aos métodos de avaliação, técnica cirúrgica utilizada, morbidade, eficácia clínica e estabilidade de resultados. A utilização da tomografia computadorizada para a avaliação da eficiência da ERMAC é uma opção atual e ainda pouco divulgada. Consequentemente, os parâmetros anatômicos para a utilização deste método ainda não foram totalmente estabelecidos. Os objetivos do presente estudo foram avaliar a confiabilidade da metodologia proposta e as alterações esqueléticas maxilares decorrentes da ERMAC com a utilização do método de avaliação por tomografia computadorizada. No período de junho de 2004 a maio de 2005, 15 pacientes, sendo 10 do sexo feminino, foram submetidos a ERMAC. A técnica cirúrgica utilizada constou de osteotomia maxilar do tipo Le Fort I, sem osteotomia da sutura ptérigo-maxilar, associada a osteotomia sagital mediana do palato. O aparelho expansor utilizado foi do tipo Hyrax. Os pacientes foram submetidos a exames de tomografia computadorizada, em tomógrafos de múltiplos detectores, no pré-operatório e após 6 meses, utilizando-se metodologia idealizada para a avaliação específica deste procedimento cirúrgico. Para a determinação do padrão das alterações transversais e ântero-posteriores, medidas lineares e angulares foram realizadas diretamente na estação de trabalho dos aparelhos de tomografia. Através de imagens obtidas nas aquisições tomográficas axiais e em reconstruções coronais, as regiões anterior, média e posterior da maxila foram avaliadas separadamente. A área de secção transversa da maxila foi também calculada. Após a avaliação dos resultados observou-se que a confiabilidade do método foi estatisticamente comprovada. Um significativo aumento da área de secção transversa da maxila foi observado (p<0.05). Entretanto, o padrão de expansão transversa não se mostrou uniforme. O aumento das dimensões transversas nas regiões anterior e média foi estatisticamente comprovado. Não foi observada expansão transversa significativa na região posterior da maxila. Ao se avaliar a relação entre a abertura do parafuso expansor e a efetiva expansão esquelética da maxila, observou-se que esta foi menor que a abertura do parafuso, em termos absolutos. O aumento transverso relativo à expansão do parafuso foi estatisticamente maior nas regiões anterior e média da maxila do que em sua região posterior. Em conclusão, a avaliação por tomografia computadorizada para a análise das alterações esqueléticas da região maxilar, em pacientes submetidos à ERMAC é metodologia confiável e reprodutível. A expansão transversa da maxila decorrente do procedimento de ERMAC utilizado no presente estudo acarretou uma expansão não uniforme da maxila, com predomínio da expansão transversa nas regiões anterior e média.
Surgically assisted rapid palatal expansion is the procedure of choice for treating transverse maxillary deficiency in mature patients. Some controversies regarding surgically assisted rapid palatal expansion remain, mainly concerning technical aspects such as type and location of osteotomy sites, as well as surgical morbidity, clinical efficiency, and stability. The evaluation of transverse expansion is still a theme of discussion. On conventional anteroposterior radiographs, anatomical structures are superimposed, resulting in a high number of image artifacts, as well as hindering the tracing and evaluation. The use of computed tomography as a method of evaluating the efficiency of this procedure has not been widely reported. Consequently, few landmarks for use in evaluating maxillary expansion have been defined. The goals of the present study were to define parameters to assess skeletal changes after surgically assisted palatal expansion, to evaluate the reliability of the proposed method and to use computed tomography to assess those parameters. From June of 2004 to May of 2005, 15 patients underwent surgically assisted rapid palatal expansion (a modified Le Fort I maxillary osteotomy without pterygomaxillary separation, together with a sagital palatal osteotomy) according to a defined protocol, using a Hyrax appliance. To determine the pattern of transversal and anteroposterior expansion, linear and angular measurements were performed on multislice computed tomography, using computed software directly on the workstation. The anterior, intermediate and posterior portions of the maxilla were evaluated separately, using a specific method, in axial acquisition and coronal reconstructed views. The cross-sectional area of the maxilla was calculated to obtain general information about maxillary expansion. The reliability of the method was statistically confirmed. Significant maxillary overall expansion was observed. However, different patterns of expansion were seen in the three regions analyzed. In the anterior and intermediate portions of the maxilla, the increase in maxillary width was significantly greater than that observed in the posterior portion. The opening of the jackscrew was greater than skeletal expansion. Comparing jackscrew opening and transverse expansion, the same pattern of asymmetric expansion was verified. No change was observed in anteroposterior dimensions. The method of computed tomography evaluation is a useful tool for evaluation of surgically assisted rapid palatal expansion changes. The accurate evaluation of the postoperative changes was heavily dependent upon images acquired through computed tomography. An overall maxillary expansion was confirmed. However, transverse expansion of the maxilla achieved through surgically assisted rapid palatal expansion without pterygoid plate separation was less than uniform.
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Katerji, Suhair. "Etude de la dysmorphose craniofaciale chez le rat Dumbo." Doctoral thesis, Universite Libre de Bruxelles, 2009. http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/210286.

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Le rat Dumbo présente un aspect malformatif évoquant certains syndromes crânio-faciaux humains. La compréhension du phénotype Dumbo pourrait expliquer les événements cellulaires et moléculaires à l’origine de ces syndromes. Le données recueillies chez le rat Dumbo et comparées à celles du rat Wistar sont susceptibles de constituer de précieuses informations éventuellement transposables à l’espèce humaine.

La première étape de cette étude a consisté en des analyses morphologiques et morphométriques afin de vérifier les perturbations morphologiques communes entre les rats Dumbo et les syndromes malformatifs humains :la brièveté des os zygomatique, maxillaire, mandibulaire et la position basse des oreilles. Ces analyses ont été réalisées sur les squelettes embryonnaires âgés de 16 jours à 21 jours de rats Dumbo et Wistar à l’aide d’une coloration in toto au Bleu Alcian – Alizarine. La deuxième étape de cette étude consistait en une analyse cytogénétique. Pour ce faire, nous avons établi le caryotype du rat Dumbo et nous l’avons comparé avec le caryotype du rat Wistar. L’étape suivante fut de procéder à l’analyse histologique des malformations crânio-faciales chez le rat Dumbo en observant la chondrogenèse pendant la morphogenèse crânio-faciale. Enfin, l’examen de l’expression des gènes Msx1 sens (S) ,Msx1 antisens (AS) et Dlx1 dans l’extrémité céphalique des rats Dumbo a été réalisé par les techniques de RT–PCR (Reverse Transcription Polymerase Chain Reaction method). Des estimations semi-quantitatives ont été validées en utilisant des dilutions ADNc du rat Wistar. Des densitométries de la densité d’amplicons fluorescence ont été réalisées à l’aide du logiciel VilberLourmat Bio1D software.

Les résultats obtenus ont permis de caractériser de manière précise les malformations crânio-faciales chez le rat Dumbo.

1-\
Doctorat en Sciences biomédicales et pharmaceutiques
info:eu-repo/semantics/nonPublished

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31

Freitas, Erika Cristina Lopes Burrone de. "Estudos moleculares em anomalias craniofaciais raras : sindrome blefaroqueilodontica e efeitos de linha media facial com hipertelorismo." [s.n.], 2009. http://repositorio.unicamp.br/jspui/handle/REPOSIP/312238.

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Orientadores: Vera Lucia Gil da Silva Lopes, Iscia Lopes Cendes
Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas
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Resumo: A Síndrome Blefaroqueilodôntica (BCD) e os Defeitos de Linha Média Facial com Hipertelorismo (DLMFH) são defeitos craniofaciais raros. Por esse motivo, os estudos de grandes casuísticas têm sido limitados. Contribuição científica significativa neste assunto tem sido dada por nosso grupo, que delineou características clínicas e diretrizes para seguimento de longo prazo e evidenciou achados neuroradiológicos em ambas as anomalias. Embasado nesses achados preliminares e evidências recentes da literatura pertinente, foi possível estabelecer uma estratégia inicial para investigação etiológica da BCD e dos DLMFH, sendo os objetivos desse projeto: investigar a etiologia da BCD nos indivíduos afetados pela síndrome, por meio de estudo dos genes candidatos IRF6, P63, OSR2, TBX10, FOXE1, SHH, FGF8 e PAX3; pesquisar, nos indivíduos com DLMFH, a presença de mutações nos genes candidatos SHH, FGF8 e PAX3; identificar, em ambas as malformações, possíveis alterações cromossômicas; e, por último, associar os achados clínicos detectados nas investigações anteriores aos possíveis achados moleculares. Foram utilizadas técnicas de sequenciamento direto, array-CGH, genotipagem automática e hibridação in situ por fluorescência. Não foi possível relacionar nenhuma mutação pontual nos genes estudados associadas às malformações em questão, pois não foram encontradas alterações gênicas patogênicas. Entretanto foram detectadas em pacientes com DLFMH três aberrações cromossômicas em regiões distintas do genoma, tratando-se de um caso de duplicação no cromossomo 6 (paciente DLMFH7), um caso com deleção no cromossomo 9 e duplicação no cromossomo 20 (paciente DLMFH10) e um caso de deleção no cromossomo 2 (paciente DLMFH1). Nesse último, o gene PAX3 encontrava-se dentro da região deletada, confirmando a hipótese inicial de que alguns genes de desenvolvimento estão envolvidos na etiologia dos DLMFH. Conclui-se, portanto, que em indivíduos com DLMFH, a técnica de array-CGH pode ser útil para detecção de aberrações cromossômicas diversas e o aconselhamento genético deve ser individualizado
Abstract: The Blepharocheilodontic Syndrome (BCD) and Midline Facial Defects with Ocular Hypertelorism (MFDH) are rare craniofacial anomalies. Considering the rarity of these two groups of congenital defects, studies with large casuistry have been limited. Our group has significantly contributed to the scientific knowledge about both anomalies, delineating clinical characteristics, evidencing neurological findings and designing protocols for long term follow-up. Based in these preliminary findings and recent evidences of pertinent literature, it was possible to determine an initial etiologic investigation strategy for the BCD and the MFDH. The objectives of this project are to investigate the etiology of the BCD in affected individuals through IRF6, P63, OSR2, TBX10, FOXE1, SHH, FGF8 and PAX3 candidate genes study; to search MFDH patients for mutations in the SHH, FGF8 and PAX3 candidate genes; to identify, in both syndromes, possible chromosomal anomalies; and finally, to associate the detected clinical findings in previous investigations to the molecular results. The direct sequencing, array-CGH, automatic genotyping and FISH were the molecular techniques used in this study. It was not possible to relate any punctual mutation in the studied genes associated to the syndromes investigated since none pathogenetic alteration was found. Although, chromosomal anomalies in different locations of the genome were detected in three MFDH patients, a chromosome 6 duplication (in patient MFDH7), a chromosome 9 deletion and chromosome 20 duplication (in patient MFDH10), and a chromosome 2 deletion (in patient MFDH1). In the latter case, the PAX3 gene was inside the deleted region, supporting the initial hypothesis that some development genes are involved in the MFDH etiology. Therefore, it can be concluded that in MFDH patients, the array-CGH investigation can be useful to detect a wide range of chromosomal anomalies and the genetic counseling must be individualized
Doutorado
Ciencias Biomedicas
Doutor em Ciências Médicas
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32

Costa, André de Mendonça. "Reconstrução de defeitos ósseos cranianos em ratos com células-tronco de polpa dentária humana: estudo experimental de neoformação óssea." Universidade de São Paulo, 2009. http://www.teses.usp.br/teses/disponiveis/5/5158/tde-10062010-180557/.

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Os defeitos da calota craniana causados por traumas severos, neoplasias, cirurgias ou deformidades congênitas representam um grande desafio para os cirurgiões. O uso de enxertia óssea autóloga continua sendo o método de tratamento padrão ouro, embora apresente morbidade na área doadora e seja considerado insuficiente para reconstrução de grandes defeitos. Recentemente, com o advento da bioengenharia tecidual, novas expectativas surgiram na regeneração óssea. O objetivo deste estudo foi desenvolver um modelo experimental em ratos para o estudo de deformidades craniofaciais e verificar se as células-tronco humanas provenientes de dentes decíduos seriam capazes de regenerar defeitos críticos em calota craniana de ratos não imunossuprimidos. Foram realizados dois defeitos ósseos de espessura total com diâmetro de 5 x 8 mm na região biparietal. O lado esquerdo foi preenchido com membrana de colágeno, enquanto o lado direito com membrana de colágeno associada a células-tronco humanas provenientes de dentes decíduos. Essas células foram caracterizadas previamente in vitro como células mesenquimais. A eutanásia dos animais foi realizada no 7º, 21º, 30º e 60º dia de pós-operatório e amostras de tecido ósseo foram extraídas para realização da análise histológica. A análise da presença de células humanas no novo osso formado foi confirmada através do estudo molecular. A linhagem de células-tronco humanas provenientes de dentes decíduos foi positiva para células-tronco mesenquimais e sua diferenciação em tecido ósseo também foi evidenciada in vitro. Foi observada a formação óssea após 21 dias de cirurgia nos dois lados, sendo o lado direito um osso mais maduro. A reação da cadeia de polimerase para DNA humano foi amplificada apenas no lado direito demonstrando que existiam células humanas nesse novo osso formado. O uso de células-tronco de dentes decíduos humanas em ratos não imunossuprimidos não evidenciou rejeição durante o período estudado. Os achados sugerem que o modelo experimental descrito poderá ser utilizado para o estudo dos defeitos ósseos cranianos em cirurgia craniofacial e que o uso de células-tronco humanas provenientes de dentes decíduos associado à membrana de colágeno parece representar uma importante estratégia para a reconstrução de tecidos ósseos e seu uso pode ser considerado uma opção para o reparo de grandes defeitos ósseos cranianos.
Repair of bone defects caused by severe trauma, resection of tumors, and congenital deformity remains a big challenge to surgeons. As a gold standard for the treatment of bone defects in clinic, autologous bone grafts are usually limited by considerable donor site mobility and available supply of tissue that can be harvested. Recently, tissue engineering has become a promising approach for bone regeneration. The main aim of this study is to create an experimental surgical protocol and evaluate the capacity of human dental pulp stem cells isolated from deciduous teeth, to reconstruct critical size cranial bone defects in nonimmunosuppressed rats. Bilateral 5 x 8 mm cranial full-thickness defects of parietal bone were created. The left side was supplied with collagen membrane only and the right side with collagen membrane and human dental pulp stem cells. Cells were used after in vitro characterization as mesenchymal cells. Animals were euthanized at 7, 21, 30 and 60 days postoperatively and cranial tissue samples were taken from the defects for histologic analysis. Analysis of the presence of human cells in the new bone was confirmed by molecular analysis. The human dental pulp stem cells lineage was positive for the four mesenchymal cell markers tested and showed osteogenic in vitro differentiation. The bone formation was observed 21 days after surgery on both sides, but a more mature bone was present in the right side. Human DNA was polymerase chain reaction-amplified only at the right side, indicating that this new bone had human cells. The use of human dental pulp stem cells in nonimmunosuppressed rats did not cause any graft rejection during this period. Our findings suggest that surgical protocol created may ultimately be used in experimental studies of cranial bone defects in craniofacial surgery and the use of human dental pulp stem cells together with collagen membrane seems to be a promising strategy for in vivo bone tissue reconstruction and their use might provide an option to repair human large cranial bone defects.
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33

Dornelles, Rodrigo de Faria Valle. "Expansão craniana com molas: estudo experimental em coelhos." Universidade de São Paulo, 2010. http://www.teses.usp.br/teses/disponiveis/5/5158/tde-22122010-160240/.

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A expansão craniana com o uso de molas tem demonstrado eficácia no tratamento das anormalidades craniofaciais, tais como as craniossinostoses. A ação expansora exercida pelas molas tem sido observada tanto quando colocadas entre as margens parietais dos ossos do crânio, como quando lateralmente à sutura sagital, principalmente nas escafocefalias. No presente estudo foi criado um modelo experimental com coelhos, e feita uma avaliação descritiva do comportamento da calota craniana e das suturas sob ação de molas. Foram utilizados 13 coelhos Nova Zelândia com quatro semanas de vida, divididos em quatro grupos: grupo I, foram implantados no crânio marcadores de amálgama para controle; no grupo II, marcadores de amálgama e osteotomia da sutura sagital; no grupo III, marcadores de amálgama, osteotomia da sutura sagital e colocação de uma mola expansora na região interparietal e, no grupo IV, marcadores de amálgama, craniotomia parassagital linear com colocação da mola. Os animais foram sacrificados com duas, quatro, oito e doze semanas. Foi realizado controle radiológico com avaliação do afastamento dos marcadores de amálgama, da variação dos ângulos cefalométricos e das medidas da base do crânio, bem como um estudo histopatológico da região de colocação das molas. Nos grupos com o uso de molas a separação dos bordos da craniotomia foi maior do que naqueles sem a utilização de mola. Houve ossificação em todos os grupos, com maior rapidez no grupo II. O crescimento ósseo deu-se a partir dos bordos e da profundidade. Não foram observadas diferenças significativas no padrão histopatológico da regeneração óssea entre os grupos com colocação de mola na região interparietal e parassagital. O modelo experimental com coelhos se mostrou adequado às análises propostas pelo estudo. Concluiu-se que houve osteogênese por distração nos grupos III e IV e que apresentaram uma expansão craniana semelhantes.
Spring-mediated skull expansion has proven to be effective in the treatment of craniofacial abnormalities, such as craniosynostosis. The use of springs in cranial expansion has been studied both in the sagittal and in parasagittal regions, especially in scaphocephaly. A rabbit model was used in the present study to analyze the effects of springs on the cranial vault and sutures. Thirteen 4-week-old New Zealand rabbits were used and divided into 4 groups: group I, amalgam markers were used as control; in group II, amalgam markers and osteotomy of the sagittal suture; in group III, amalgam markers and osteotomy of the sagittal suture with implant of an expansible spring in the interparietal region and in group IV, amalgam markers and linear parasagittal craniectomy with springs. Animals were sacrificed after 2, 4 and 12 weeks. Radiological control with assessment of the amalgam markers, variation of cephalometric angles and cranial base measurements, as well as the histopathological analysis of the spring implant area were carried out. In the groups using springs distraction of the craniectomy borders was greater than in those that did not use springs. Ossification was observed in all of the groups and was faster in group II. Bone growth started from the borders and depth. There were no significant differences in the histopathological pattern of bone regeneration between the groups with spring implant in the interparietal and parasagittal region. The rabbit model proved to be adequate for the analysis proposed by the study. It was concluded that there was osteogenesis caused by distraction in groups III and IV, with similar skull expansion rates.
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34

Monlleo, Isabella Lopes. "Atenção a pessoas com anomalias craniofaciais no Brasil : avaliação e propostas para o Sistema Unico de Saude." [s.n.], 2008. http://repositorio.unicamp.br/jspui/handle/REPOSIP/312230.

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Orientador: Vera Lucia Gil da Silva Lopes
Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas
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Resumo: As primeiras ações para inclusão da atenção a pessoas com anomalias craniofaciais (ACF) no Sistema Único de Saúde (SUS) ocorreram na década de 1990 e culminaram com a criação da Rede de Referência no Tratamento de Deformidades Craniofaciais (RRTDCF). Esta rede foi avaliada por Monlleó em 2004, momento em que foram identificados centros de atendimento a pessoas com ACF vinculados ao SUS, mas não à RRTDCF. Objetivos: (1) avaliar os centros de ACF não-RRTDCF; (2) discutir a política de atenção à saúde para ACF do Brasil; (3) elaborar cadastro dos centros estudados e (4) elaborar proposta de banco de dados de fendas orofaciais para o Brasil. Resultados: 82 centros de atendimento a pessoas com ACF participaram da avaliação. Estes centros estão concentrados no Sudeste e em universidades e compreendem serviços isolados, multiprofissionais e associações de pais. Apenas seis serviços multiprofissionais seguem critérios internacionais de composição de equipes. Nestes, odontólogos e cirurgiões são os especialistas mais freqüentes. Geneticistas clínicos estão envolvidos com aconselhamento genético em 35 serviços, enquanto em 30, outros profissionais realizam esta atividade. Sessenta e dois centros aderiram ao cadastro proposto. O banco de dados consiste em um projeto de registro clínico e familial de pessoas com fendas orofaciais atendidas em unidades da RRTDCF. Em torno deste, cinco projetos satélites foram elaborados: (1) banco de DNA; (2) avaliação da organização interna das unidades; (3) banco de profissionais de saúde e de protocolos de tratamento; (4) estudos de seguimento pós-cirúrgico, morbidade e mortalidade; (5) avaliação de satisfação dos usuários. Conclusões: os centros não-RRTDCF se sobrepõem à RRTDCF quanto à distribuição, procedimentos, clientela e financiamento. Iniqüidades, disparidades regionais e falta de integralidade permanecem como problemas. Acredita-se que a superação desses problemas requer a reformulação da política de atenção a pessoas com ACF e, para tanto, apresentam-se diretrizes. O cadastro de centros é uma ferramenta pública para minorar dificuldades de acesso a informações. Por sua vez, o banco de dados poderá fornecer subsídios para avaliação contínua dos serviços e para a reformulação da política de saúde para ACF no SUS
Abstract: Health care for persons with craniofacial anomalies (CFA) officially started in Brazil in the nineties. It was consolidated through the Reference Network for Craniofacial Treatment (RRTDCF). The RRTDCF was evaluated by Monlleo in 2004 when several non-RRTDCF units operating in the Unified Health System (SUS) were identified. Aims: (1) to evaluate health care provided through non-RRTDCF units; (2) to inform the debate about craniofacial health care policy in Brazil; (3) to build up a record on CFA units; (4) to build up a Brazilian database on orofacial clefts. Results: 82 non-RRTDCF units took part of the survey. They are mainly located in the southeast, and in universities. They are funded by the government and comprise independent clinics, multiprofessional teams and parental associations. Only 6 multiprofessional units meet the international criteria for minimal CFA teams. Clinical geneticists are involved in genetic counselling in 35 units, however in 30 it is provided by untrained professionals. Sixty two units agreed to participate in the national record proposed. The Brazilian database on orofacial clefts was designed to record clinical and familial information on patients assisted through the RRTDCF. Additionally, five satellite projects were built: (1) biobank of DNA; (2) general care assessment; (3) database of healthcare professionals and assessment of treatment protocols; (4) follow-up studies on surgical treatment and morbidity/mortality and (5) patient/parent satisfaction studies. Conclusion: non-RRTDCF units overlap RRTDCF regarding distribution, treatment provided, type of CFA treated, and funding. The current system does not ensure equity and coordination of care, and keeps up regional disparities. It is believed that these problems may be overcome through changes in the current national health policy for CFA in Brazil and suggestions are given in this regard. The national record on CFA units is a tool in the public interest and can improve equity of access to services. The database, on the other hand, is an achievable strategy to set up appraisal and audit systems and to support the reformulation of health policy for persons with CFA in the SUS
Doutorado
Genetica Medica
Doutor em Ciências Médicas
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35

Monlleo, Isabella Lopes. "Anomalias craniofaciais, genetica e saude publica : contribuições para o reconhecimento da situação atual da assistencia no Sistema Unico de Saude." [s.n.], 2004. http://repositorio.unicamp.br/jspui/handle/REPOSIP/313531.

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Orientador: Vera Lucia Gil da Silva Lopes
Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas
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Resumo: As anomalias craniofaciais estão entre os defeitos congênitos humanos mais freqüentes e demandam assistência multiprofissional, integral e especializada, cujo custo é elevado. O médico geneticista destaca-se na equipe por ter habilidades para a caracterização etiológica e nosológica dessas condições, fundamentais para o aconselhamento genético e a correta obtenção de dados epidemiológicos. Todavia, o acesso ao tratamento ainda é precário em muitas nações, motivo pelo qual a Organização Mundial de Saúde vem estimulando pesquisas sobre oferta de serviços e qualidade da assistência prestada. Além disso, é reconhecido que a ampla variação da qualidade e dos custos da assistência estão relacionados às características estruturais e funcionais dos serviços. A primeira iniciativa para atenção a portadores de Anomalias Craniofaciais no Sistema Único de Saúde do Brasil ocorreu em 1993. Com a criação da Rede de Referência no Tratamento de Deformidades Craniofaciais, o atendimento foi ampliado, contando atualmente com 29 centros credenciados. Até o momento, esses centros não foram caracterizados. Os objetivos deste trabalho foram avaliar a organização dessa Rede, descrever a estrutura e funcionamento dos centros que a integram e verificar a oferta e o acesso à genética clínica nesses locais. Para coleta dos dados, foi utilizado um questionário semi-estruturado, remetido por correio. Os resultados demonstram agregação de centros no Sudeste, em universidades e na área de fissuras labiopalatais, com atendimento de rotina em cerca de 90% deles. A denominação da rede de assistência não parece corresponder à sua atual abrangência. As equipes estão constituídas de acordo com critérios americanos em 14 e, com europeus, em cinco centros participantes do estudo. Há geneticistas clínicos em 13 centros. Dentre esses, 61,8% contam com apenas um especialista dessa área. Apesar da baixa inserção do geneticista, em 22 centros, pais e pacientes solicitam informações sobre etiologia e prevenção que são fornecidas em 80,0% dos centros; todavia em 55% deles essa atividade é realizada por médicos não geneticistas e outros integrantes da equipe. Em conclusão, os dados sugerem a necessidade de revisão da definição, objetivos, abrangência e critérios de credenciamento dos centros de atendimento e caracterizam a precariedade da oferta e do acesso à genética clínica na Rede de Referência no Tratamento de Deformidades Craniofaciais
Abstract: Craniofacial anomalies are one of the most common birth defects in man, which have considerable medical costs in view of the long, specialized and complex treatment. The presence of the Clinical Geneticist on the team is important for clinical and etiologic characterization of these anomalies, genetic counseling and epidemiologic register. As the access for treatment is not easy in many countries, the World Health Organization launched a project for research availability and quality of the specialized services. Previous research demonstrates that variation of costs and quality of the services were related with theirs structural and functional characteristics, as well. The first initiative for public craniofacial anomalies health care in Brazil was in 1993. An important improvement occurred with the creation of the Net for Craniofacial Deformities Treatment, which is composed by 29 centers. Until now, these centers had not been studied before. The aims of this study were to evaluate the Net for Craniofacial Deformities Treatment, to describe the structural and functional characteristics of these centers and the access for genetic evaluation and genetic counseling for individuals and families in them. Data were collected by a questionnaire mailed for all these centers. The results showed an increased of centers in Southeast and in universities. Cleft lip and palate is the main clinical condition treated. Routine attendance occurred in 90% of the centers. Teams¿ composition is similar to American criteria in 14 of the centers and to European, in 5. The denomination of this assistance net does not seem in accordance to its actual activities. Clinical geneticist was present in 13 centers and 61,8% had one professional. In spite of few Clinical Geneticists in the composition of the teams, in 22 centers of attendance patients and parents asked for etiology and prevention, which have been done in 80% of them. These informations are transmitted by a non-specialized physicians and others members of the team in 55% of the centers. These data suggested that it would be necessary the revision of definition, goals, activities and standards for inclusion of the craniofacial centers. They also demonstrated that the availability and the access for clinical geneticist is not enough in the Net for Craniofacial Deformities Treatment of Brazil
Mestrado
Genetica Medica
Mestre em Ciências Médicas
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36

Hiester, John David 1964. "Craniofacial pattern profile analysis of individuals with frontonasal malformation." Thesis, 1994. http://hdl.handle.net/1805/4368.

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Indiana University-Purdue University Indianapolis (IUPUI)
Frontonasal malformation, FNM, was first described by Hoppe in 1859. FNM is an anomaly that is characterized by ocular hypertelorism, broad nasal root, lack of a nasal tip, V-shaped hair, prolongation onto the forehead (widow's peak), anterior cranium bifidum occultum, median facial cleft affecting the nose, upper lip, and/or palate, and uni- or bilateral clefting of the ala nasi. The anomalies noted in FNM may be explained as a single malformation. If the nasal capsule fails to develop properly, the primitive brain vesicle fills the space normally occupied by the capsule, thus producing anterior cranium bifidum occultum, an arrest in the positioning of the eyes, and a lack of formation of the nasal tip. The condition presents clinically with variable expressions as sporadic cases and infrequently in familial cases. The present study is the first attempting to quantify and characterize FNM via anatomic radiographic measurements. The lateral (LA) and posterior-anterior (PA) cephalometric radiographs of twenty-four individuals, both sporadic and familial, with FNM were analyzed for comparison of linear and angular measurements with previously published data of a "normal," i.e. unaffected, population standard. Usual and customary cephalometric points were identified and located, then digitized into the computer. Twenty-nine measurements included the previously diagnosed anomalous features of hypertelorism, medial nasal cavity, and palatal shelves, as well as other facial features. The radiographs of individuals with FNM have anatomic features that are unusual and distinct to the specific malformation. The data from this research suggest that patients with FNM, regardless of a genetic or sporadic predisposition, have a midface deficiency in height and depth, an increased interorbital width with possible increased orbital socket width, and a longer zygomatic buttress. Also, the familial cases tend to have a flatter cranial base than the sporadic cases. Furthermore, the familial patients might be a different type of FNM since this subgroup shows narrower zygomatic widths. The patients with surgical procedures demonstrated improvement different from the growth of those patients who did not have surgery. The hypothesis that the facies of a patient with frontonasal malformation is different from the "normal" control population is supported by this research. The differences between the familial and sporadic patients tend to support the general theory that genetic predisposition is less severe than FNM that occurs randomly.
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37

David, David John 1940. "The Australian Craniofacial Unit, 1975-1996." Thesis, 1997. http://hdl.handle.net/2440/38285.

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Sets out the principles of craniofacial surgery and how they have been utilised to form the Australian Craniofacial Unit. Progress of the organisation is mapped over twenty one years using selected published papers in which the author has in some way contributed to the development of teaching, research and service in craniofacial surgery. Papers are grouped so as to show the progress made in the areas of trauma, the craniosynostoses, rare craniofacial clefts, frontal ethmoidal meningoencephaloceles, craniofacial tumours, as well as research and development.
Thesis (M.D.) -- University of Adelaide, Dept. of Surgery, 1999
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38

Simpson, Ellie Kristina. "Variation in cranial base flexion and craniofacial morphology in modern humans." Thesis, 2005. http://hdl.handle.net/2440/37790.

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Cranial base flexion has been used extensively as a baseline or standard from which to interpret differences in craniofacial growth and morphology. Lateral cephalometric radiographs of 414 adults representing seven samples from around the world were compared for variation in cranial base and facial morphology. The samples represent Australian Aboriginal, New Zealand Maori ( Polynesian ), Thai, Chinese, white American, African Sotho / Xhosa / Zulu and African Khoi / San populations. Seven angles of cranial base flexion, five craniofacial angles and nine cranial base and facial dimensions were measured on tracings of lateral cephalometric radiographs. Numerous significant correlations were found between cranial base flexion angles, craniofacial angles and dimensions of the cranial base and craniofacial skeleton. A positive correlation was found between the orientation of the foramen magnum, clivus and the anterior cranial base, with a negative correlation between these angles and the orientation of the hard palate. There was also a parallel relationship between the orientation of the foramen magnum and the anterior cranial base ( measured from pituitary point to nasion ). Cranial base flexion, craniofacial angles and dimensions differed significantly between some samples. Despite this, there was no evidence of distinct facial types between samples. Multivariate statistics revealed some discrimination between some samples for dimensions ; however, if angles were used alone, less than 50 % of individuals could be correctly assigned to their sample of origin. Most of the variation could be attributed to variation between individuals, rather than variation between samples. The range of variation in cranial base flexion is considerable, and needs to be taken into account when comparing samples. Flexion of the cranial base is generally insufficient to distinguish people from different geographic samples. The functional and evolutionary significance of the relationship between the orientation of the foramen magnum and cranial base flexion is discussed for its potential usefulness as a reference line for interpreting craniofacial morphology.
Thesis (Ph.D.)--Medical School and Dental School, 2005.
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39

David, David John 1940. "The Australian Craniofacial Unit, 1975-1996 / David John David." 1997. http://hdl.handle.net/2440/38285.

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Includes bibliographical references.
2 v. :
Title page, contents and abstract only. The complete thesis in print form is available from the University Library.
Sets out the principles of craniofacial surgery and how they have been utilised to form the Australian Craniofacial Unit. Progress of the organisation is mapped over twenty one years using selected published papers in which the author has in some way contributed to the development of teaching, research and service in craniofacial surgery. Papers are grouped so as to show the progress made in the areas of trauma, the craniosynostoses, rare craniofacial clefts, frontal ethmoidal meningoencephaloceles, craniofacial tumours, as well as research and development.
Thesis (M.D.)--University of Adelaide, Dept. of Surgery, 1999
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40

Tumbleson, Danika M. "Treatment and genetic analysis of craniofacial deficits associated with down syndrome." Thesis, 2014. http://hdl.handle.net/1805/6432.

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Indiana University-Purdue University Indianapolis (IUPUI)
Down syndrome (DS) is caused by trisomy of human chromosome 21 (Hsa21) and occurs in ~1 of every 700 live births. Individuals with DS present craniofacial abnormalities, specifically an undersized, dysmorphic mandible which may lead to difficulty with eating, breathing, and speech. Using the Ts65Dn DS mouse model, which mirrors these phenotypes and contains three copies of ~50% Hsa21 homologues, our lab has traced the mandibular deficit to a neural crest cell (NCC) deficiency in the first pharyngeal arch (PA1 or mandibular precursor) at embryonic day 9.5 (E9.5). At E9.5, the PA1 is reduced in size and contains fewer cells due to fewer NCC populating the PA1 from the neural tube (NT) as well as reduced cellular proliferation in the PA1. We hypothesize that both the deficits in NCC migration and proliferation may cause the reduction in size of the PA1. To identify potential genetic mechanisms responsible for trisomic PA1 deficits, we generated RNA-sequence (RNA-seq) data from euploid and trisomic E9.25 NT and E9.5 PA1 (time points occurring before and after observed deficits) using a next-generation sequencing platform. Analysis of RNA-seq data revealed differential trisomic expression of 53 genes from E9.25 NT and 364 genes from E9.5 PA1, five of which are present in three copies in Ts65Dn. We also further analyzed the data to find that fewer alternative splicing events occur in trisomic tissues compared to euploid tissues and in PA1 tissue compared to NT tissue. In a subsequent study, to test gene-specific treatments to rescue PA1 deficits, we targeted Dyrk1A, an overexpressed DS candidate gene implicated in many DS phenotypes and predicted to cause the NCC and PA1 deficiencies. We hypothesize that treatment of pregnant Ts65Dn mothers with Epigallocatechin gallate (EGCG), a known Dyrk1A inhibitor, will correct NCC deficits and rescue the undersized PA1 in trisomic E9.5 embryos. To test our hypothesis, we treated pregnant Ts65Dn mothers with EGCG from either gestational day 7 (G7) to G8 or G0 to G9.5. Our study found an increase in PA1 volume and NCC number in trisomic E9.5 embryos after treatment on G7 and G8, but observed no significant improvements in NCC deficits following G0-G9.5 treatment. We also observed a developmental delay of embryos from trisomic mothers treated with EGCG from G0-G9.5. Together, these data show that timing and sufficient dosage of EGCG treatment is most effective during the developmental window the few days before NCC deficits arise, during G7 and G8, and may be ineffective or harmful when administered at earlier developmental time points. Together, the findings of both studies offer a better understanding of potential mechanisms altered by trisomy as well as preclinical evidence for EGCG as a potential prenatal therapy for craniofacial disorders linked to DS.
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