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1
Al-Masri, Maher. "Limitations of bone formation in oral implantology : inhibition of osteoblast functions by gingival tissues." Thesis, Queen Mary, University of London, 2010. http://qmro.qmul.ac.uk/xmlui/handle/123456789/356.
Повний текст джерелаАнотація:
Clinical observation suggest that bone formation is influenced by the environmental niche where it takes place and specifically that soft connective tissues may inhibit the bone healing process. The aim of the studies described in this thesis is to test the hypothesis that fibroblasts inhibit the differentiation and function of osteoblasts in vitro. To address this aim the ability of fibroblasts and their supernatants to inhibit osteoblast differentiation was investigated. In addition, the inhibitory effects of gingival and periodontal ligament fibroblasts were compared. Next Bone Morphogenetic Proteins (BMPs) and their antagonists were tested for their ability to modulate the activity of fibroblast supernatants. Finally the effects of fibroblast supernatants on osteoblast chemotactic responses were investigated. Primary fibroblasts were isolated from rat gingivae, skin, oral mucosa and periodontal ligament (PDL) using explant cultures. Primary osteoblast cultures were established by enzymatic digestion of neonatal rat calvariae. In other experiments the osteoblastic cell line ROS 17/2.8 was used. Osteoblast differentiation was assessed by measuring alkaline phosphatase (ALP). In co-culture experiments using 3-D collagen gels and diffusion chamber inserts fibroblasts strongly inhibited osteoblast differentiation. Furthermore conditioned medium from superficial connective tissues fibroblasts consistently inhibited osteoblast differentiation (greater than 50% inhibition of ALP expression. In contrast, PDL cells strongly stimulated ALP expression (greater than 100% increase). Stimulation of ROS 17/2.8 cells with BMP-2 increased ALP expression (more than 3 fold increase with 10ng/ml BMP-2), and this effect could be completely blocked by the BMP-antagonist 100ng/ml noggin. Similarly conditioned media from gingival, oral mucosal and skin fibroblasts totally suppressed the effects of BMP-2. In contrast, PDL conditioned media stimulated ALP expression in additively with BMP-2, and his effect could also be blocked by noggin. Using a micro-well Boyden Chamber both PDGF and BMP-2 caused a dose-dependent increase in chemotaxis. However fibroblast conditioned medium totally blocked the chemotactic effects on BMP-2, but had no effect on PDGF-induced chemotaxis. Overall these studies demonstrate that fibroblasts from superficial connective tissues (gingival, oral mucosa and skin) can inhibit osteoblast function by secretion of BMPantagonists and that superficial connective tissues and PDL are distinct in respect to their role in bone healing. Further studies are needed to identify the specific molecular identity of this inhibitory activity and to extend these observations to an in vitro model. However in the longer term it is proposed that information on the regional expression of BMP inhibitors may lead to novel therapeutic interventions to promote bone growth in periodontal and implant related bone regeneration procedures.
2
Diakonoff, Hadrien. "Les responsabilités liées à l'implantologie orale." Electronic Thesis or Diss., Université Paris Cité, 2023. http://www.theses.fr/2023UNIP7097.
Повний текст джерелаАнотація:
L'implantologie orale est une discipline de la chirurgie-dentaire qui rencontre, depuis les années 2000, un essor considérable en France et dans le monde. Cette discipline vise à compenser l'absence ou la perte de dents par l'utilisation et la fourniture d'une grande variété de dispositifs médicaux. Le traitement implantaire est ainsi mis en oeuvre par une grande partie des chirurgiens-dentistes français au profit, chaque année, de plusieurs centaines de milliers de patients. L'appréhension de cette discipline par le droit est réelle. Il est en effet possible de traiter des normes portant sur l'innovation et le cycle de vie des dispositifs médicaux, de l'encadrement réglementaire des activités des différents acteurs du secteur ou encore, des différentes obligations légales qui s'imposent aux chirurgiens-dentistes et aux établissements de santé en ce qui concerne la pratique de l'implantologie orale. L'analyse de ces différentes problématiques conduit inéluctablement à s'intéresser aux questions de responsabilité pouvant naître des activités et des pratiques des différentes personnes physiques et morales intervenant dans le domaine de l'implantologie orale. Si l'utilisation et la fourniture de dispositifs médicaux, en implantologie orale, conduisent à prendre en considération le régime de responsabilité des produits défectueux, d'autres responsabilités intéressent également le fabricant, le distributeur ou l'importateur de dispositifs médicaux en France. Par exemple, la responsabilité contractuelle, la garantie des vices cachés ou la responsabilité pénale en cas d'infraction à certaines dispositions réglementaires en vigueur. La responsabilité de l'État peut également être recherchée au titre d'une carence dans l'exécution des missions de l'agence sanitaire compétente en matière de dispositifs médicaux. De manière subsidiaire, il convient de porter une attention particulière sur les responsabilités des chirurgiens-dentistes libéraux et des établissements de santé du secteur privé et du secteur public, qui mettent en oeuvre le traitement implantaire au quotidien. En cas de dommage corporel, dommage qui peut survenir au décours d'une des étapes de ce traitement invasif, différentes démarches peuvent être engagées à leur encontre par la victime, aux fins de réparation ou de sanction. Si les différentes voies amiables et contentieuses permettant à une victime d'accident médical d'obtenir la réparation de ses préjudices sont connues et éprouvées, la mise en oeuvre pratique de la démarche de réparation est semée d'embûches et conduit, parfois, à une impasseOral implantology is a field of dentistry that has experienced significant growth in France and worldwide since the 2000s. Oral implantology aims to compensate for the absence or loss of teeth by using a wide variety of medical devices. Implant treatment is thus implemented by a large number of French dentists every year, benefiting several hundred thousand patients. Health law has a real impact on this medical discipline. It is indeed possible to address norms regarding the innovation and life cycle of medical devices, the regulatory framework of the activities of the different actors in the sector, or even the various legal obligations that apply to dentists and healthcare facilities concerning the practice of oral implantology. The analysis of these different issues inevitably leads to an interest in questions of responsibility that may arise from the activities and practices of the various individuals and entities involved in the field of oral implantology. If the use of medical devices in oral implantology leads to considering defective products liability, other responsibilities also concern the manufacturer, distributor, or importer of medical devices in France. Contractual liability, warranty for hidden defects, or criminal liability in the event of infringement of certain regulatory provisions in force. The State's liability may also be sought for a failure to carry out the missions of the competent health agency in the field of medical devices. As a subsidiary matter, particular attention should be paid to the responsibilities of dentists and healthcare facilities that implement implant treatment. In the event of patient harm, which can occur during one of the stages of this invasive treatment, various actions may be taken against them by the victim for the purposes of compensation or sanction. While the various amicable and contentious paths allowing a victim of a medical accident to obtain compensation for their damages are known, the practical implementation of the compensation process is fraught with obstacles and sometimes leads to a dead end
3
Calderón, Cortez Iván. "Consideraciones anatómicas en implantología." Bachelor's thesis, Universidad Nacional Mayor de San Marcos, 2014. https://hdl.handle.net/20.500.12672/10263.
Повний текст джерелаАнотація:
El documento digital no refiere asesorRevisa el procedimiento quirúrgico para la colocación de implantes. Siendo fundamental el conocer la anatomía del maxilar y mandíbula aplicada a la implantología. En las áreas donde el tejido óseo disminuye es importante realizar procedimientos quirúrgicos de colocación de implantes cortos, y en regiones posteriores es comparable a la de las regiones anteriores, además se pueden alcanzar la misma tasa de éxito clínico con implantes cortos si se compara con los de mayor longitud, siendo su uso una alternativa terapéutica predecible a corto y medio plazo. Es importante conocer los límites anatómicos para la colocación de implantes, a través de tomografía computarizada Cone Beam, puesto que el análisis volumétrico dará la certeza de los reparos anatómico.
Trabajo académico
4
Tassera, C. "Ideazione e progettazione di un clinical trial in implantologia orale." Doctoral thesis, Università degli Studi di Milano, 2007. http://hdl.handle.net/2434/64350.
Повний текст джерелаАнотація:
A total of 97 (in 43 patients) Nobel Replace implants of various diameters and length were placed: 42 in mandibles and 45 in maxillas. The implant types and dimensions, insertion torque, surgery technique and bone quality and quantity (according to Lekholm and Zarb s classification) were recorded at the time of implant placement for each individual site. Intraoral radiographs from the time of implant placement and at the 6-month (upon delivery of the final prosthesis) and 1-2 year follow-up visits were taken for evaluation. The cumulative survival rate was 96.8% for all implants after 1 year. The mean marginal bone loss during 1 year follow-up after implant placement was 1.36 mm. All failures but one occurred before the final prostheses were placed. The outcome of the present prospective 1-year study indicates that Nobel Biocare Replace implant system showed a high reliability. We aim to complete the 5 years of follow-up in the 21 clinics involved in order to obtain the largest sample possible.
5
Boix, Damien. "Etude de la biofonctionnalité d'un substitut osseux injectable : applications en implantologie orale." Nantes, 2003. http://www.theses.fr/2003NANT28VS.
Повний текст джерелаАнотація:
Comparée aux techniques d'implantation différée, la pose d'un implant dentaire dans le même temps opératoire que l'extraction augmente le confort du patient puisqu'elle ne nécessite qu'une seule intervention chirurgicale et qu'elle permet une réhabilitation prothétique plus précoce. L'implantologie immédiate reste cependant une technique moins utilisée car le manque de concordance entre la morphologie des implants et celle de l'alvéole engendre l'existence d'un défaut péri-implantaire qui peut compromettre la réussite finale de l'intervention. L'objectif de ce travail était de mettre au point un biomatériau de substitution osseuse injectable (IBS) permettant de favoriser l'ostéointégration des implants dentaires. Préalablement développé au sein de l'Equipe Mixte INSERM 99-03, l'IBS est un matériau composite formé de granules de phosphate de calcium biphasé (BCP) et d'un gel de polymère cellulosique, l'hydroxy-propyl-méthyl-cellulose (HPMC). Dans un premier temps, il a été vérifié que les propriétés physico-chimiques de ce substitut osseux correspondaient au cahier des charges défini pour une utilisation péri-implantaire. Deux études pré-cliniques ont ensuite été conduites afin de déterminer le meilleurs compromis injectabilité/granulométrie. Une première expérimentation animale réalisée sur des comblements alvéolaires, a ainsi permis de tester l'IBS composé de BCP de granulométrie moyenne comprise entre 200 et 500 [micro]m. Le pouvoir ostéoconducteur de l'IBS a ainsi pu être quantifié et il a été montré que ce biomatériau limitait la résorption de la crête alvéolaire après extraction dentaire. Cependant, la granulométrie 200/500 [micro]m a semblé incomplètement adaptée à l'implantologie orale car elle a présenté une cinétique de résorption trop longue par rapport aux périodes de mise en nourrice habituellement recommandées. Une deuxième étude a alors montré que lorsque le BCP contenu dans l'IBS présentait une granulométrie moyenne comprise entre 40 et 80 [micro]m, le biomatériau favorisait l'ostéointégration d'implants posés immédiatement après extraction. En effet, outre ses propriétés rhéologiques adaptées à la situation clinique, l'IBS 40/80 [micro]m a permis une repousse osseuse rapide autour de l'implant avec résorption complète du biomatériau. L'ensemble de ces résultats laisse entrevoir l'utilisation de l'IBS comme une alternative à l'utilisation des greffes osseuses autogènes et des techniques de régénération tissulaires guidées en implantologie orale immédiateCompared with the techniques of differed implantation, dental implant placement in same operational time that the extraction increases the comfort of the patient since it requires only one surgical operation and that it allows an earlier prosthetic rehabilitation. The immediate implantology remains however a less used technique. Indeed the no-concordance between the implant morphology and that of the socket generates the existence of a bone gap which can compromise the final success of the intervention. The objective of this work was to develop an injectable bone substitute (IBS) to support the osseointegration of dental implants. Previousiy developed in the laboratory INSERM 99-03, the IBS is a composite of calcium phosphate granules (BCP) with a cellulosic derivative (hydroxy-propyl-methyl-cellulose [HPMC]). Firstly, it was checked that the physicochemical properties of this bone substitute fitted with the product specifications for a peri-implant application. Two preclinical trials were then led in order to determine the best compromise between injectability and granulometry. A first animal experiment was carried out on socket filling, to check the efficacy of IBS containing BCP granules with a granulometry ranging between 200 and 500 [micro]m. The osteoconductive properties of the IBS could thus be evaluated and it was shown that this biomaterial prevented the alveolar crest resorption after dental extraction. With regards to the kinetics of resorption higher than the usually recommended periods of bone healing, the 200/500 [micro]m granulometry seemed incompletely adapted to oral implantology. A second study with IBS containing BCP granules ranging between 40 and 80 [micro]m, has then shown that this biomaterial supported the osseointegration of implants immediately placed after extraction. Indeed, in addition to its rheological properties adapted to the clinical situation, IBS 40/80 [micro]m allowed a rapid bone ingrowth around the implant with complete resorption of the biomaterial. Viewed together, these results highlight the possibility to use IBS as an alternative to autologous bone graft and tissue guided regeneration in immediate dental implantology
6
Charrier, Jean-Luc. "Implantologie orale : influence de la topographie de surface sur la cytocompatibilité des biomatériaux." Paris 5, 1996. http://www.theses.fr/1996PA05M106.
Повний текст джерелаАнотація:
L'objectif de cette étude est d'évaluer l'influence d'une modification de la topographie de surface d'un biomatériau sur le comportement des cellules cultivées à son contact. Nous avons choisi de travailler sur deux matériaux déjà éprouvés en clinique (Titane c. P. , PMMA). L'efficacité des traitements de surface est évaluée en microscopie mécanique à balayage sur le plan topographique et en mouillabilité sur le plan énergétique. Les rugosités sont significativement différentes entre les groupes. Les mesures de l'angle de contact avec les liquides de référence témoignent de l'influence de la rugosité sur les conditions d'interactions du matériau avec le milieu environnant. Les différentes topographies de surfaces des matériaux sélectionnées sont exposées aux tissus cibles représentatifs de la situation in vivo en implantologie orale. Nous utilisons des cultures de tissus osseux et épidermiques embryonnaires de poulet et développons une technique de culture organotypique d'épithélium de gencive humaine afin d'évaluer quantitativement les comportements cellulaires de viabilité, migration, de multiplication et d'adhésion. Globalement l'analyse quantitative, au contact des différences topographies de surface, est en faveur de comportements cellulaires dépendant de l'état de surface. Le dernier chapitre est consacré à l'étude qualitative du modèle de culture de gencive humaine sur titane lisse ou rugueux. L'ultrastructure des voiles cellulaires diffère en fonction de la rugosité des surfaces. L'étude des cytokératines, par les méthodes combinées d'éléctrophorèse et d'immuno-marquage, valide notre modèle en démontrant la nature épithéliale des cellules cultivées. En conclusion et dons nos marges d'investigations, la rugosité influence le comportement cellulaire, le plus souvent, selon une loi du tout ou du rien.
7
Sanon, Clarisse. "Lumière sur la zircone 3Y-TZP utilisée en implantologie orale : Etude de la relation entre la microstructure et la durabilité." Thesis, Lyon, INSA, 2014. http://www.theses.fr/2014ISAL0138.
Повний текст джерелаАнотація:
La zircone 3Y-TZP présente un grand intérêt pour les applications dentaires, en implantologie orale, elle semble être un matériau extrêmement prometteur: elle allie une biocompatibilité à un aspect esthétique satisfaisant et présente aussi des propriétés mécaniques très supérieures aux autres céramiques. Ces bonnes propriétés mécaniques sont intimement liées à la microstructure du matériau, elle-même directement liée aux procédés d’élaboration comme nous l’a rappelé l’alarmante série de ruptures de plus de 800 têtes de prothèses de hanche en zircone au début des années 2000, due au phénomène de vieillissement de ce matériau. Cependant, les études cliniques menées à ce jour ne font toujours pas état des interrelations existant entre la microstructure, les propriétés mécaniques et la sensibilité au vieillissement. Il était donc primordial de valider et d’appliquer les connaissances acquises dans le domaine des sciences des matériaux pour l’application de la zircone 3Y-TZP en implantologie oral. C’est l’objectif de notre première publication. Nous avons également développé, dans notre deuxième publication, un protocole d’évaluation permettant dans un premier temps, d’évaluer l’effet de l’état de surface et de la microstructure sur la résistance mécanique d’implants neufs, puis de suivre leurs cinétiques de vieillissement tout en analysant l’évolution de la microstructure et son influence sur la résistance mécanique au cours du vieillissement. Tout cela permettant in fine, de prédire la durabilité d’un type d’implant. Nous avons par la suite, développé un programme informatique permettant la détection et la quantification du vieillissement pour un volume donné. Cette détection de la zone vieillie ou transformée est basée sur des modifications microstructurales caractéristiques engendrées lors du vieillissement. Enfin, nous avons pu mettre en évidence l’occurrence du phénomène de vieillissement in vivo, par l’analyse d’explants issus d’une étude clinique et démontrer leur probable implication dans ces cas d’échec. Le logiciel informatique de traitement d’image développé a été également, appliqué aux explants dans le but de mettre en lumière et d’expliciter l’occurrence du phénomène de vieillissement in vivo, afin de sensibiliser les acteurs de ce marcher aux problématiques rencontrées et d’optimiser de ce dispositif médical, à la lumière des connaissances actuelles3Y-TZP zirconia is gaining interest in oral implantology, it seems to be a promising material with good biocompatibility, esthetic appearance and also the highest mechanical properties for a ceramic. These mechanical properties are closely related to the microstructure of the material itself directly related to production processes as we recalled the alarming series of breaks of more than 800 heads of zirconia hip replacements in the early 2000, due to the aging phenomenon of the material. However, clinical studies to date are still not state of the interrelationships between microstructure, mechanical properties and sensitivity to aging. It was therefore important to validate and apply the knowledge gained in the field of materials science for the application of 3Y-TZP zirconia oral implantology. This is the goal of our first publication. We also have developed in our second publication, a protocol to assess the effect of the surface modification and microstructure on the mechanical strength of new implants and follow their kinetics of aging and also, the evolution of the microstructure and its influence on the mechanical strength during aging, to predict the durability of a type of implant. We have subsequently developed a computer program for the detection and quantification of the aging for a given volume. This detection of the aged or transformed area is based on microstructural modifications produced during aging. Finally, we have been able to demonstrate the occurrence of the phenomenon of aging in vivo, by analyzing explants from a clinical study and demonstrate their involvement in the case of dental implant failure. The image processing developed was also applied to the explants in order to highlight and explain the occurrence of in vivo aging phenomenon. The objective is to optimize this medical device, in the light of current knowledge
8
ASSAF, JOSEPH. "Formes cliniques des implants endo-osseux et etude de la biocompatibilite des materiaux utilises en implantologie orale." PARIS 6, DENTAIRE, 1988. http://www.theses.fr/1988PA06H009.
Повний текст джерела
9
Noharet, Renaud. "Contribution à l'assurance qualité des dispositifs médicaux en implantologie orale : à propos de la précision du placement implantaire." Thesis, Lyon 1, 2014. http://www.theses.fr/2014LYO10109/document.
Повний текст джерелаАнотація:
L'assurance qualité est une discipline récente dans le domaine médical, d'autant plus en odontologie. Sa mise en oeuvre passe dans notre discipline essentiellement par l'application de règles d'exigences vis-à-vis des dispositifs médicaux utilisés au sein des cabinets dentaires. Les implants, les piliers, les prothèses implantaires mais également les guides chirurgicaux sont des exemples appliqués au domaine implantaire. Cette technique chirurgico-prothétique se doit d'être exécutée dans les meilleurs conditions avec une exigence optimale : chaque acte pouvant avoir des conséquences sur le patient et/ou l'avenir du traitement. Afin de répondre aux exigences d'assurance qualité du traitement implantaire, il semble que les guides chirurgicaux statiques puissent être un moyen afin d'améliorer le placement implantaire impactant donc la qualité de la thérapeutique mise en place. Dans un premier temps, les notions d'assurance qualité et des dispositifs médicaux sont remis en lumière, notamment au travers du filtre de l'implantologie orale. Ensuite, la qualité du traitement implantaire est discutée : des bases historiques jusqu'aux connaissances d'aujourd'hui. Il est important de maitriser l'évolution de cette technique et des outils associées afin de comprendre et donc d'utiliser les outils diagnostics et thérapeutiques à notre disposition aujourd'hui. Le dernier temps de ce travail constitue l'évaluation des outils actuels en implantologie (CFAO, stéréolithographie, chirurgie guide statique, informatique) au travers d'une étude sur sujets anatomiques. Cette étude évalue la précision du positionnement implantaire avec des guides dits conventionnels et des guides de chirurgie guidée statique. Cette précision est évaluée par comparaison des images préalables de planification et des examens tridimensionnels post-opératoiresThe quality assurance is a recent discipline in the medical domain, all the more in odontology. Its implementation passes in our discipline essentially by the application of rules of requirements towards medical devices used within dental surgeries. Implants, abutments, implant’s prosthesis but also the surgical guides are examples applied to the domain. This surgico-prosthetic technique owes be executed in the best conditions with an optimal requirement: every act which can have consequences on the patient and/or the future of the treatment. To meet the requirements of quality assurance of the treatment, it seems that the static surgical guides can be a way to improve the placement of implants thus impacting on the quality of the organized therapeutics. At first, the notions of quality assurance and medical devices are handed in light, in particular through the filter of the oral implantology. Then, the quality of the treatment is discussed: historic bases until the knowledge of today. It is important to master the evolution of this technique and tools associated to understand and thus use tools diagnoses and therapeutic at our disposal today. The last time of this work establishes) the evaluation of the current tools implantologie (CAD-CAM, stereolithography, surgery guides static, IT) through a study on anatomical subjects. This study estimates the precision of the implant’s positioning with conventional said guides and guides of static guided surgery. This precision is estimated by comparison of the preliminary images of planning and the post operative threedimensional examinations
10
Zanón, Serer Juan. "Elevación de seno bilateral; Bio-Oss® versus Bio-Oss®/Collagen. Estudio clínico prospectivo randomizado." Doctoral thesis, Universitat Internacional de Catalunya, 2017. http://hdl.handle.net/10803/456484.
Повний текст джерелаАнотація:
La rehabilitación implantológica del sector posterior del maxilar superior viene condicionada por la atrofia ósea secundaria a la pérdida de uno o mas dientes y a la consecuente neumatización del seno maxilar, que reducen la disponibilidad ósea para la inserción de implantes dentales. Una de las técnicas mas utilizadas para resolver esta situación es la elevación de seno. Técnica quirúrgica consistente en el abordaje maxilar, la elevación de la membrana sinusal y relleno del espacio creado entre el hueso residual y la membrana. El material de injerto utilizado para el relleno y aumento de la altura ósea en el maxilar ha sido motivo de múltiples estudios y sigue siendo una línea de investigación. Material autólogo, xenoinjerto, aloinjerto o materiales sintéticos se utilizan con diferentes resultados como injertos en el seno maxilar. El objetivo de este proyecto de tesis doctoral es la comparación histólogica e histomorfométrica de dos materiales, Bio-Oss® y Bio-Oss®/Collagen en elevaciones de seno bilaterales y la comparación de los cambios dimensionales logrados con cada uno de los materiales de estudio. Metodología: se realizaron elevaciones de seno con abordaje lateral y de forma bilateral a 18 pacientes. A cada paciente se le realizó dos elevaciones de seno, y se le asignó de forma aleatoria un material de estudio en cada uno de los cuadrantes. Tras un periodo mínimo de 6 meses, en el momento de la inserción de los implantes se tomó una muestra ósea de cada seno injertado para su estudio histológico e histomorfométrico. Resultados: el análisis histomorfométrico demostró una composición histológica similar en los senos regenerados con Bio-Oss® y los regenerados con Bio-Oss®/Collagen, en términos de hueso nuevo formado, partícula residual y tejido conectivo. Ambos materiales resultaron en un aumento de la altura ósea que suficiente para la inserción de implantes. Conclusiones: tras los resultados obtenidos, podemos concluir que los dos materiales estudiados resultan adecuados para ser utilizados en cirugía de elevación de seno, sin que exista diferencias significativas en cuanto a la composición histológica y en cuanto a cambios dimensionales entre uno y otro.
11
Lozano-Carrascal, Naroa. "Topical Application of Bisphosphonates to Enhance Alveolar New Bone Formation." Doctoral thesis, Universitat Internacional de Catalunya, 2017. http://hdl.handle.net/10803/456485.
Повний текст джерелаАнотація:
This PhD thesis is a compendium of three publications, which sets out to broaden our knowledge and understanding of the topical application of bisphosphonates alone or mixed with a bone graft in alveolar bone defects, to evaluate the potential capacity of them to preserve/enhance alveolar new bone formation.
In recent years, research has focused on improving bone substitutes to achieve faster and better regeneration by morphologic and biochemical modification. Bisphosphonates are a group of drugs that reduce bone resorption by inhibiting the formation, recruitment activity of mature osteoclasts; and promoting their apoptosis. In addition, some bisphosphonates enhance osteoblast differentiation and activity. Thence, it has been demonstrated that topical application of a bisphosphonates can minimize the bone resorption following muco-periostial flap surgery or in peri-
implantitis; improve the osteoconductive and regenerative capacity of a biomaterial; prevent the surface resorption of onlay bone grafts; or reduce post-extraction dimensional changes.
Mandibular second premolars (P2) and first molars (M1) were extracted from six Fox-Hound dogs. P2 were categorized as small defects (SD) and M1 as large defects (LD). Four random groups were created: SC (small control defects with MP3®), ST (small test defects MP3® + pamidronate), LC (large control defects with MP3®), and LT (large test defects MP3® + pamidronate). At four and eight weeks of healing the percentages of new bone formation (NB), residual grafts (RG) and connective tissue (CT) were analysed by histology and histomorphometric analysis. To complement the information already obtained from histological analysis, the samples were evaluated through scanning electron microscopy (SEM), and Energy dispersive X-ray spectroscopy (EDX), to identify the chemical elements present into the biomaterial and surrounding tissues, for understanding the biomaterial’s degradation process. The study was complemented with a systemic literature review of the articles published between January 2000 and December 2016, that evaluated in vivo the effects of the topical application of bisphosphonates on bone regeneration/preservation in alveolar defects. A total of 154 abstracts were identified, of which 18 potentially relevant articles were selected; a final total of nine papers were included for analysis.
Histomorphometric and histologic analysis of the present pilot study demonstrated that after 4 and 8 weeks of healing, higher new bone formation for test groups (ST and LT) treated topically with pamidronate, compared with SC and LC respectively; residual graft was significantly higher in both control groups (SC and LC) compared to test (ST and LT) groups; and connective tissue percentage was higher in large defects (LC and LT) compared to small defects (SC and ST). SEM analysis revealed more mineralized bone in test groups (ST and LT) compared with control groups, demonstrated by higher percentages of Ca obtained from EDX spectroscopy.
Within the limitations of this experimental study, the findings suggest that porcine xenografts (MP3®) modified with pamidronate favours the new bone formation and increased the porcine xenograft substitution/replacement after 4 and 8 weeks of healing. These results are in accordance with the conclusions obtained from the systematic review. Despite the comparison of the findings of the selected studies was made difficult by the heterogeneity of the articles, the topical application of bisphosphonate solution would appear to favour new bone formation in alveolar defects, and boosts the regenerative capacities of biomaterials resulting in increased bone density.
12
Macripò, Valentina. "Gestão do insucesso em implantologia." Master's thesis, 2019. http://hdl.handle.net/10284/8278.
Повний текст джерелаАнотація:
A implantologia, desde há vários anos, é a primeira escolha no tratamento de edentulias únicas e múltiplas. Esta disciplina cirúrgica e protética é agora aplicada diariamente e garante altas taxas de sucesso a longo prazo, ainda que, em alguns casos, possam ocorrer complicações biológicas, biomecânicas e microbiológicas comprometendo a viabilidade das reabilitações. Este trabalho tem como objetivo apresentar conteúdos e conceitos através de uma revisão narrativa da literatura existente sobre as múltiplas causas de perda de implantes e a gestão do seu insucesso. Para tal, realizou-se uma pesquisa bibliográfica com recurso a artigos publicados em revistas indexadas, com recurso aos motores de busca na internet, tais como PubMed e B-On. Foram selecionados artigos publicados entre os anos 2000 e 2018, escritos em Português, Inglês e Italiano.Implantology, for several years, has been the first choice in the treatment of single and multiple edentulous. This surgical and prosthetic discipline is now applied daily and guarantees high rates of success in the long term, even though, in some cases, biological, biomechanical and microbiological complications may occur, compromising the viability of rehabilitation. This work aims to present contents and concepts through a narrative review of the existing literature on the multiple causes of loss of implants and the management of its failures. To this end, a bibliographic search was conducted using articles published in indexed journals, using Internet search engines such as PubMed and B-On. We selected articles published between 2000 and 2018, written in Portuguese, English and Italian.
13
Pinto, Francisco Daniel da Costa. "Relatório de atividade clínica." Master's thesis, 2020. http://hdl.handle.net/10400.14/31033.
Повний текст джерелаАнотація:
O ramo de Medicina Dentária visa a manutenção da saúde oral preocupando-se com os tecidos moles e duros da cavidade oral. Este ramo está em constante inovação através de diversas técnicas que visam a tratar, não só problemas funcionais, como problemas estéticos de modo mais conservador possível. Este relatório de atividade clínica (RAC) foi realizado durante o período de 20 de Setembro de 2019 e 13 de Março de 2020. Primeiramente, neste RAC foram expostos os dados relacionados com as consultas marcadas das quais se destacam as realizadas, as faltas e desmarcações e os reencaminhamentos. Obteve-se o número de primeiras consultas e as de continuidade tal como as consultas realizadas como operador e assistente. Os pacientes encontram-se agrupados segundo o género (feminino e masculino) e por faixa etária. Estes também foram agrupados, segundo os seus hábitos de higiene e hábitos tabágicos. De seguida, procedeu-se ao registo dos dados sobre a atividade clínica por área disciplinar, bem como um breve enquadramento teórico, incluindo as consultas realizadas por área tal como as faltas e desmarcações e os reencaminhamentos. Por último, são expostos dois casos clínicos diferenciados no contexto das áreas disciplinares de Dentisteria Operatória e Cirurgia Oral/Medicina Oral, realizados na Clínica Universitária, com todo detalhamento técnico e resultados obtidos.Dentistry seeks to maintain oral health worrying about the soft and hard tissues of the oral cavity. It is always innovating through the use of different techniques that treat, not only functional problems as well as aesthetics problems as conservative as possible. This report was made between September 20th, 2019, and March 13th, 2020. First in this report were exposed to data regarding scheduled appointments, absences, and unchecked appointments and forwarding. It was obtained the number of first appointments and continuity appointments made as operator and as an assistant. The patients are grouped by gender (female and male) and by age. They were also grouped according to their hygiene habits and their smoking habits. After that, data on clinical activity by disciplinary area were recorded, as a brief theoretical framework including consultations that were carried out by disciplinary areas as well as absences and unchecked appointments and the forwarding. Lastly, two differentiated clinical cases are exposed to Restorative Dentistry and Oral Surgery/Oral Medicine, performed at University Clinic, presenting all technical details and results obtained.
14
Maia, António Augusto Alves Nunes. "O papel da vitamina D na implantologia dentária." Master's thesis, 2017. http://hdl.handle.net/10284/6154.
Повний текст джерелаАнотація:
Abordamos o conhecimento da importância da vitamina D na implantologia dentária. É
do conhecimento clínico que a vitamina D que produzimos por exposição a radiação
solar é benéfica para a saúde óssea, no entanto novos estudos parecem alongar o
espectro de ação desta vitamina que se começa a redesenhar com um perfil diferente.
Demonstrou-se que há influencia benéfica para os músculos, nervos, articulações e
metabolização óssea, contudo a incidência de défice na população vem aumentando
atingindo níveis preocupantes. A vitamina D pode ser vantajosa coordenando a
metabolização óssea e possivelmente mediando a remodelação de osso após a colocação
de um implante, no entanto os estudos são escassos e controversos no que toca aos
resultados apesar da tendência ser para a avaliação, correção e suplementação quando
em falta.In this work we try to show the role that vitamin D takes in dental implantology. It’s a clinical fact that vitamin D is beneficial for a healthy bone structure, nonetheless new studies seem to stretch the reach of this vitamin redrawing it biological role. It was shown that vitamin D had a beneficial effect on muscles, nerves, joints and bone metabolism. The numbers that show a high deficit are rising all over the population, reaching concerning levels. Vitamin D can be advantageous coordinating bone metabolization and it also may mediate bone remodeling efforts post implant placement. Studies are still scarce and controversial about a clear conclusion, but the trend appear to be to evaluate the levels and proceed to corrections with supplementations or change of habits when deficit is shown.
15
Ferreira, Eunice Cinderela de Almeida. "Vitamina D na medicina dentária." Master's thesis, 2017. http://hdl.handle.net/10284/6157.
Повний текст джерелаАнотація:
Conhecida como a “vitamina do sol”, a vitamina D é um micronutriente essencial para um funcionamento saudável do organismo.
A vitamina D é um percursor hormonal esteroide, lipossolúvel, que pode ser encontrado sob duas formas: ergocalciferol ou vitamina D₂ (sintetizada na epiderme pela ação da radiação ultravioleta da luz solar) e o colecalciferol ou vitamina D₃ (proveniente da dieta de origem vegetal).
A síntese cutânea de vitamina D depende de vários fatores, como a latitude da zona geográfica, a estação do ano, a hora do dia, a superfície corporal exposta ao sol e duração da exposição, uso de cremes com proteção solar, pigmentação da pele, obesidade e idade.
Atualmente, a elevada prevalência de níveis inadequados de vitamina D é encarada como um problema de saúde pública que afeta vários países da Europa e os EUA.
A vitamina D assume um papel primordial no metabolismo do cálcio, uma vez que é uma das hormonas responsáveis pela manutenção das concentrações adequadas de cálcio e fósforo, tanto séricos quanto extracelulares, para que sejam garantidas uma variedade de funções metabólicas.
Nos últimos anos, o papel fisiológico da vitamina D tem sido amplamente estudado, sabendo-se atualmente, que as funções da “vitamina solar” vão muito mais além da regulação do metabolismo ósseo.
A presente dissertação tem como principal objetivo explorar a fisiologia e o metabolismo da vitamina D e discutir o seu papel em determinadas manifestações patológicas da deficiência desta vitamina, particularmente ao nível da cavidade oral.Known as the "sunshine vitamin", vitamin D is an essential micronutrient for a healthy functioning of the body. Vitamin D is a steroid hormone precursor, liposoluble, that can be found in two forms: ergocalciferol or vitamin D₂ (synthesized in the epidermis by the action of ultraviolet radiation from sunlight) and cholecalciferol or vitamin D₃ (from the diet of plant origin). The cutaneous synthesis of vitamin D depends on several factors, such as the latitude of the geographical area, the season of the year, time of day, body surface exposed to the sun and duration of exposure, use of sunscreen creams, skin pigmentation, obesity and age. Currently, the high prevalence of inadequate vitamin D levels is seen as a public health problem that affects several countries in Europe and the US. Vitamin D plays a key role in calcium metabolism, as it is one of the hormones responsible for maintaining adequate calcium and phosphorus concentrations, both serum and extracellular, to ensure a variety of metabolic functions. In recent years, the physiological role of vitamin D has been widely studied, and it is now known that the functions of the "solar vitamin" go far beyond the regulation of bone metabolism. The present dissertation aims to explore the physiology and metabolism of vitamin D and discuss its role in certain pathological manifestations of vitamin D deficiency, particularly at the level of the oral cavity.
16
Oliveira, Ana Carolina Nunes. "Complicações em implantologia oral associadas à menopausa." Master's thesis, 2017. http://hdl.handle.net/10284/6526.
Повний текст джерелаАнотація:
Durante a Menopausa existe um maior grau de comprometimento na densidade óssea podendo levar
à perda de dentes naturais, dificultar a fixação de próteses e implantes, além de aumentar a
possibilidade de fraturas de mandíbula e maxila, por diminuição da resistência e aumento da
fragilidade óssea. Uma vez que, a porosidade do osso aumenta, o risco de fratura eleva-se. Por
todos estes motivos, durante esta faixa etária, questiona-se o sucesso dos implantes dentários. Esta
dissertação tem como objetivo avaliar, de acordo com a literatura existente, a viabilidade da
colocação de implantes dentários durante a menopausa.
Para a execução desta revisão da literatura, foi desenvolvida uma pesquisa entre Janeiro e Agosto
de 2017 recorrendo à biblioteca Ricardo Reis da Universidade Fernando Pessoa e às bases
eletrónicas PUBMED e B-ON utilizando as “palavras-chaves” estabelecidas. Em suma, na
realização da presente dissertação, foram utilizados 23 artigos científicos e uma obra literária.There is a greater compromise of bone density during menopause, which may lead to tooth loss, therefore the fixation of prostheses and implants are harder, which increases the possibility of fracture of the jaw due to decreased of resistance and increased of bone fragility. Since the porosity of the bone increases, the risk of fracture increases. For all these reasons, during this age group, the success of dental implants is questioned. This dissertation aims to evaluate, according to the existing literature, the viability of placing dental implants during menopause. For the execution of this literature review, a survey was carried out between January and August 2017, using the Library Ricardo Reis of the Fernando Pessoa University and the electronic bases PUBMED and B-ON using the established "key words". In conclusion, in the accomplishment of the present dissertation, 23 scientific articles and a literary work were required.
17
Silva, Ana Margarida Correia. "Implantologia em pacientes oncológicos." Master's thesis, 2016. http://hdl.handle.net/10400.26/17445.
Повний текст джерелаАнотація:
Dissertação para obtenção do grau de Mestre no Instituto Superior de Ciências da Saúde Egas MonizA doença oncológica da cabeça e do pescoço constitui um grave problema de saúde a nível mundial, representando o sexto cancro mais prevalente na população. O cancro e os seus tratamentos acarretam efeitos adversos extremamente debilitantes quer a nível físico quer a nível psicológico. O médico dentista faz parte de uma equipa multidisciplinar que atua no tratamento dos doentes oncológicos, desempenhando um papel essencial no diagnóstico, acompanhamento e preparação do paciente no que diz respeito às sequelas provocadas pelas rigorosas terapêuticas. A reabilitação oral destes pacientes é considerada um dos maiores desafios na área da medicina dentária. A utilização de implantes dentários tem demonstrado ser uma opção promissora, podendo melhorar significativamente a componente estética e a função oral (mastigação, deglutição e fala), restabelecendo a qualidade de vida aos doentes, porém, não existe um consenso entre os médicos dentistas, relativamente a esta opção reabilitadora. Apesar do aparente sucesso, há uma escassez de estudos a longo prazo que avaliem o êxito da colocação de implantes em pacientes oncológicos. Os objetivos primordiais desta monografia são, abordar a importância do médico dentista no acompanhamento dos pacientes oncológicos durante todas as fases do tratamento, incluindo a sua reabilitação com implantes dentários e analisar a influência dos principais fatores que condicionam a eficácia da osteointegração e a taxa de sucesso dos implantes.
18
Noriega, Jorge. "Utilización de planificación digital en el entrenamiento en implantologia oral." 2021. http://hdl.handle.net/10757/657182.
Повний текст джерелаАнотація:
Festival de Innovación Educativa de la UPC. Ponente: Dr. Jorge NoriegaEl primer FIE de la UPC es un espacio de docentes para docentes, en donde se compartirán las estrategias innovadoras de aprendizaje que se han venido aplicando en los últimos meses de educación online. Es una oportunidad para intercambiar conocimiento, seguir aprendiendo y atrevernos a innovar como parte del proceso de enseñanza y aprendizaje.
19
Morgado, Inês Alexandra Salgueiro. "Diagnóstico em implantologia dentária : a importância da imagiologia no planeamento pré-operatório." Master's thesis, 2019. http://hdl.handle.net/10400.26/29747.
Повний текст джерелаАнотація:
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas MonizO implante dentário é um material aloplástico colocado no maxilar ou na mandíbula, abaixo da camada mucosa. É um dispositivo que tem ganho ampla popularidade nos últimos anos, sendo uma alternativa extremamente viável à tradicional reabilitação por intermédio de uma prótese removível ou fixa. É considerado o melhor tratamento reabilitador da Medicina dentária na substituição de dentes perdidos ou ausentes e reposição da função e da estética, mas é o Médico Dentista o responsável por identificar e avaliar todos os critérios relevantes para a escolha do tratamento mais adequado ao paciente. Uma avaliação adequada e um correto plano de tratamento pré-operatório, são imprescindíveis para o sucesso da terapêutica com implantes. A imagiologia é essencial para selecionar os candidados mais aptos à colocação do implante, auxilia na identificação do local a colocar e deve, sobretudo, permitir a identificação das estruturas anatómicas vitais, como o seio maxilar, as fossas nasais, o buraco palatino e o canal incisivo, no caso de implantes na maxila; e o canal alveolar inferior e o buraco mentoniano, em implantes mandibulares. Para além disso, auxilia na verificação da necessidade ou não de uma cirurgia pré-implante; na determinação da qualidade e quantidade óssea; e deteção de processos patológicos no local selecionado para a colocação do implante e que podem inviabilizar a sua colocação. Meios radiográficos intra e extra-orais, bi ou tridimensionais, podem ser utilizados para este efeito. A radiografia periapical, radiografia oclusal, radiografia cefalométrica, ortopantomografia, imagem DentaSan, tomografia convencional, tomografia computorizada, tomografia computorizada de feixe cónico e ressonância magnética são os mais empregues. Numa fase inicial, recomenda-se a utilização da ortopantomografia, complementada, se necessário, com as radiografias periapicais,. Mas quando são precisas imagens transversais, o CBCT deve ser a técnica de eleição na aquisição de imagens pré-operatórias para a realização da cirurgia de implantes.
The dental implant is an alloplastic material placed in the jawbone or mandible, below the mucosal layer. It is a technic that has gained wide popularity in recent years, being an extremely viable alternative to traditional rehabilitation through a removable or fixed prosthesis. It is considered the best rehabilitative treatment of dental medicine in the replacement of lost or missing teeth and replacement of function and aesthetics, but it is the Dentist who is responsible for identifying and evaluating all relevant criteria for choosing the most appropriate treatment for the patient. Proper evaluation and a correct preoperative plan are important for successful implant treatment. Imaging is essential to select the most suitable candidates for placement of the implant, it helps to identify the site to be placed and must, above all, allow identification of vital anatomical structures, such as the maxillary sinus, nasal fossae, palatine foramen and incisor canal, in the case of implants in the maxilla; and the inferior alveolar canal and the mentonian foramen, in mandibular implants. In addition, they assist in verifying the need for pre-implant surgery, in determining bone quality and quantity and detecting pathological processes at the local selected for implant placement that may make it unfeasible. Intra-and extra-oral radiographic means, bi or three-dimensional, may be used for this purpose. Periapical radiography, occlusal radiography, cephalometric radiography, orthopantomography, DentaScan imaging, conventional tomography, CT scan, concomitant CT scan and MRI are the most commonly used. In an initial phase, it is recommended to use orthopantomography, supplemented, if necessary, with periapical radiographs, but when transverse images are required, CBCT should be the technique of choice in the acquisition of preoperative images for the implants.
20
Gomes, Andreia Filipa Silvestre. "Critérios de seleção dos tipos de reabilitação oral em pacientes com cancro oral : implantes vs prótese removível." Master's thesis, 2021. http://hdl.handle.net/10400.26/38688.
Повний текст джерелаАнотація:
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas MonizO cancro oral trata-se de um problema a nível da saúde mundial, sendo considerado o sexto cancro mais prevalente. O controlo do cancro da cabeça e pescoço é complexo, devido às implicações funcionais e estéticas do tratamento dos tumores dessa região. A respiração, a fala, a deglutição, a visão, o olfato, o paladar e a mastigação são apenas algumas das funções críticas da cabeça e pescoço que podem ser prejudicadas, temporária ou permanentemente, pelo tumor e/ou seu tratamento. Além disso, a estética facial e dentária é importante na forma como somos percebidos pelos outros; a autoestima e a autoconfiança podem ser gravemente afetadas, sendo assim tão importante a reabilitação oral nestes pacientes, restabelecendo a sua qualidade de vida. A reabilitação com próteses removíveis pode muitas vezes ser difícil e não adequada a certos pacientes. Isto, devido a alterações anatómicas, fisiológicas e psíquicas destes doentes. Durante vários anos estas próteses convencionais foram centrais nos tratamentos reabilitadores, no entanto apresentam um sucesso limitado e não estão aptas para resolver todos os problemas que estes pacientes enfrentam. O uso de implantes dentários osteointegrados têm vindo a revolucionar a reabilitação oral, mostrando resultados favoráveis em pacientes sujeitos a radioterapia e/ou quimioterapia do tumor da cabeça e pescoço. Com a realização desta revisão bibliográfica pretende-se avaliar os extensos danos da radioterapia e quimioterapia na cavidade oral, estabelecer os critérios de seleção da reabilitação com próteses removíveis e implantes dentários em pacientes com tumores da cabeça e pescoço e enumerar os fatores que podem afetar o prognóstico destes tipos de reabilitação. Serão consultadas as bases de dados PubMed, Medline, SciELO, Science Direct e Web of Science, com um intervalo temporal de 10 anos.
Oral cancer is a worldwide health problem, being considered the sixth most prevailing cancer. Controlling head and neck cancer is a complex matter, due to the functional and aesthetic implications of the treatment of tumours located in this area. Breathing, speaking, deglutition, sight, smell, taste and chewing are some of the main functions of the head and neck that can be harmed, temporarily or permanently by this tumour and/or its treatment. Besides this, facial and dental aesthetic are important in the way we are perceived by others, self-esteem and selfconfidence may be seriously affected, which makes oral rehabilitation very important for these patients, as it re-establishes their quality of life. Rehabilitation with removable dentures may be many times difficult and inappropriate for certain patients. This happens due to anatomical, physiological and psychological changes in these patients. For several years, conventional dentures have been central in rehabilitation treatment. However, they have limited success and are not suitable to solve all the problems that these patients have to face. The use of osteointegrated implants has been revolutionizing oral rehabilitation, showing favourable results in patients submitted to radiotherapy and/or chemotherapy to treat a tumour in the head and neck. The main purpose of this bibliographical revision is to assess the damage of radiotherapy and chemotherapy in the oral cavity, as well as to establish the criteria for selection in the rehabilitation with removable dentures and dental implants in patients with tumours in the head and neck and to enumerate the factors that may affect the prognosis of these kinds of rehabilitation. PubMed, Medline, SciELO, Science Direct and Web of Science data bases will be consulted with a ten-year interval.
21
Bandeira, Paulo Gustavo Cavalcanti. "Atualidade da cirurgia guiada na implantologia oral: uma revisão da literatura." Master's thesis, 2018. http://hdl.handle.net/10284/7172.
Повний текст джерелаАнотація:
A Odontologia moderna foi amplamente beneficiada com a disseminação dos princípios da osseointegração. Nesse cenário, os implantes dentários tornaram-se a modalidade “padrão ouro” para a reabilitação de dentes ausentes. Entretanto, o sucesso do tratamento é diretamente proporcional, dentre vários fatores, a um bom planeamento e a uma cirurgia precisa e compatível com o planeado. O avanço tecnológico, através de computadores e impressoras de última geração, é uma realidade na Implantologia Oral e faz parte, cada vez mais, do seu dia-dia. Para o desenvolvimento do tema, foi realizada uma pesquisa bibliográfica mostrando a evolução da cirurgia assistida por computador, discutindo-se vantagens, limitações e complicações das técnicas mais atuais. Este trabalho tem como objetivo atualizar o médico dentista a respeito das novas tecnologias aplicadas à Implantologia, a fim de que, baseado em pesquisas, possa oferecer ou indicar o tratamento mais adequado aos seus pacientes. Ao final do estudo, fica claro o grande potencial oferecido pela tecnologia CAD/CAM na Medicina Dentária, que tende a crescer com o desenvolvimento de novos sistemas e técnicas.The modern dentistry has greatly benefited from the dissemination of the osseointegration principles. Having this scenario set, dental implants have become the "gold standard" modality for the rehabilitation of missing teeth. However, the success of the treatment is directly proportional, among many factors, to a good accurate planning and compatible surgery according to what was planned. The technological advance in cutting edge computers and new printers is already a reality in Oral Implantology and is part of our life more than ever. For the development of the theme, a bibliographic research was carried out showing the computer assisted surgery evolution, discussing the advantages, limitations as well as complications of the most current techniques. This work aims to update the dentists regarding new technologies applied to Implantology, so that, based on research, the most appropriate treatment can be offered to patients. At the end of this study, it is extremely clear the great potential offered by CAD / CAM technology on Dental Medicine, which tends to grow with the development of new systems and techniques.
22
Lewandowski, Rosi [Verfasser]. "Laser- und navigationsgestützte orale Implantologie : eine Literaturanalyse / Rosi Lewandowski." 2007. http://d-nb.info/985406798/34.
Повний текст джерела
23
Leroi, Sandie Claire Marguerite. "Artérias sublinguais e submentais : estudo anatómico, riscos e precauções em implantologia e cirurgia oral." Master's thesis, 2020. http://hdl.handle.net/10400.26/33975.
Повний текст джерелаАнотація:
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas MonizAs artérias sublingual e submentoniana são de interesse cirúrgico, podendo estar envolvidas em acidentes hemorrágicos, devido às suas configurações anatómicas, conduzindo a alterações clínicas como a necrose lingual. O porção anterior da mandíbula deve, portanto, receber mais atenção, dadas as estruturas vitais que cruzam o foramen lingual. A prevenção dos riscos e actuação em caso de acidente é, portanto, um desafio para o médico dentista que deve ter um conhecimento anatómico detalhado para evitar complicações. Objetivos: O objetivo deste trabalho reside no estudo anatómico da artéria sublingual e submentoniana aplicado à cirurgia oral, a fim de estudar os riscos de lesões arteriais, e definir os procedimentos a serem tomados para a sua abordagem cirúrgica e a gestão de complicações intraoperatórias. Métodos: Para tentar responder a esta questão propormo-nos fazer uma revisão narrativa onde serão usados motores de pesquisa como Pubmed e Cochrane e do acervo bibliográfico do IUEM nos últimos dez anos.
The sublingual and submental arteries are two arteries of interest involved in hemorrhagic accidents during surgical arterial injuries, various pathologies or medications, due to their configurations and anatomical changes, causing clinical manifestations such as lingual necrosis. The anterior aspect of the mandible should therefore receive more attention given the vital structures crossing the lingual foramen. The prevention of risks and their management in the event of an accident is therefore a real challenge for dentist who must have a detailed anatomical in-depth knowledge of this area to avoid complications. Objectives : The objective of this work lies in the anatomical study of the sublingual and submentoniana artery applied to oral surgery, in order to study the risks of arterial injuries, and to define the procedures to be taken for its surgical approach and the management of intraoperative complications. Methods: To try to answer this question we propose to do a narrative review where search engines such as Pubmed and Cochrane and the bibliographic collection of IUEM will be used in the last ten years.
24
López, López Berta Maria. "Papel do tabaco e da higiene oral sobre a saúde das reabilitações implanto-suportadas." Master's thesis, 2019. http://hdl.handle.net/10400.26/30972.
Повний текст джерелаАнотація:
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas MonizHoje em dia a Implantologia é considerada a melhor opção de tratamento reabilitador em Medicina Dentária. Antes destes, as reabilitações eram realizadas através de próteses do tipo removíveis ou fixas, suportada por dentes e mucosas. Método mais conservador, sem que haja recurso ao suporte mucoso ou dentário, sem a necessidade de realizar qualquer desgaste dos dentes adjacentes, quando comparado por exemplo com outros tipos de reabilitação fixa. Em 1952, Per-Ingvar Bränemark descobre a osteointegração após a tentativa de tirar uma peça de titânio colocada numa tíbia. A osteointegração do implante é um processo onde se estabelece uma conexão sólida e funcional entre o osso vital e a superfície do implante o qual para além de outros factores fica submetido a uma carga oclusal. Mas esta terapia necessita de respeitar alguns procedimentos antes da sua colocação, tais como uma boa história clínica e anamnese do doente, onde se avaliarão os fatores de risco, a realização de exames complementares de diagnóstico (ortopantomografia, TAC, radiografias periapicais), de forma a avaliar as condições anatómicas e estruturais para se proceder à colocação de implantes. Um dos factores que pode comprometer o sucesso dos implantes é uma periodontite não controlada. O tabaco é um produto proveniente da secagem de folhas de plantas do género Nicotiana tabaco. O fumo do tabaco apresenta na sua constituição cerca de 4000 substâncias capazes de prejudicar os tecidos humanos. E segundo muitos autores a exposição do tecido peri-implantar aos constituintes do tabaco pode contribuir para o insucesso da reabilitação de implantes em fumadores. Os implantes com uma superfície rugosa podem favorecer o prognóstico das reabilitações implantosuportadas em pacientes fumadores. Contudo, são essenciais mais estudos para determinar qual o tratamento de superfície e quais as dimensões mais adequadas para os implantes colocados neste tipo de pacientes. Concluímos que pacientes fumadores têm um maior risco de insucesso na colocação de implantes. Já que o sucesso dos implantes depende da osteintegração e os elementos nocivos do tabaco afetam o processo normal da osteintegração,
Implantology is currently considered the best rehabilitative treatment in dentistry. Before implants , rehabilitations were performed using removable or fixed prostheses, tooth supported or complete dentures. Being the most conservative way of restoring missing teeth, without any adjacent teeth wear, when compared to other types of fixed rehabilitation. In 1952, Per-Ingvar Bränemark discovers osteointegration after attempting to remove a titanium piece placed on a tibia , procces that exict a functional and solid connection betwenn vital bone and the implat surface , among other factors implants had occlusal forces . This kind of treatment needs to have some requirements that need to be clearify before implant placement : Clinical history and anamnesis of the patient, Risk factor assessment, Complementary diagnostic exams (orthopantomography, CT scan, periapical radiographs): evaluation of available bone thickness and height for implants; determination of the distance of the nobles structures that should be avoided and not injured during the surgery, among others. Tobacco is a product derived from dry leaves of plants from the genus Nicotiana tobacco. Tobacco smoke has in its constitution about 4000 substances capable of damaging human tissues. Exposure of peri-implant tissue to tobacco constituents can contributed to the failure of implant supported rehabilitation in smokers. Rought surface implants can achive a better outcome in implants supported rehabilitation in smoker patients. Mores studies are need in order to choose the best implant surface ant the best implant desing for smokers patients
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Ramalho, Marcos Aurélio Araújo. "Efeito do plasma rico em plaquetas como opção terapêutica na implantologia oral: uma revisão narrativa." Master's thesis, 2022. http://hdl.handle.net/10284/10938.
Повний текст джерелаАнотація:
O plasma autólogo rico em plaquetas foi desenvolvido no início da década de 1970, sendo então reconhecido como um poderoso agente adesivo e hemostático. Tem sido descrito como fator importante no processo de cicatrização tecidual na área cirúrgica, uma vez que liberta fatores de crescimento que melhoram o processo de regeneração tecidual, permitindo uma reparação da integridade dos tecidos de forma mais breve e eficaz. Com este trabalho pretendeu-se realizar uma revisão bibliográfica sobre o uso do plasma rico em plaquetas, particularidades e características deste produto terapêutico, métodos de obtenção e indicações que justifiquem o seu uso clínico na implantologia dentária.Autologous platelet-rich plasma was developed in the early 1970s and was then recognized as a powerful adhesive and hemostatic agent. It has been described as an important factor in the tissue healing process in the surgical area, as it releases growth factors that improve the tissue regeneration process, allowing for a quicker and more effective repair of tissue integrity. With this work, we intended to carry out a bibliographical review on the use of platelet-rich plasma, particularities and characteristics of this therapeutic product, methods of obtaining and indications that justify its clinical use in dental implantology.
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Kříž, Pavel. "Systém na podporu rozhodování v dentální implantologii - kvalita života pacientů s implantáty." Doctoral thesis, 2012. http://www.nusl.cz/ntk/nusl-312132.
Повний текст джерелаАнотація:
Title: System to support decission making in dental implantology - quality of life of patients with dental implants Author: MUDr. Pavel Kříž Department: Paediatric Stomatology of 2nd Medical School and Faculty Hospital Motol, V Úvalu 84, 150 06 Prague 5 Supervisor: Prof. MUDr. Taťjana Dostálová, DrSc., MBA Supervisor's e-mail: tatjana.dostalova@fnmotol.cz Dental implants are the method of choice in the treatment of missing tooth/teeth replacement. Implant therapy must be preceded by a detailed examination and the overall treatment plan. As an aid for decision-making for dentists was created decision-making scheme, which gradually, logically and schematically guides the dentists in this particular situation. Health is closely related to the quality of life. Our work evaluates the oral health-related quality of life (OHRQoL) of patients with dental implants. The aim of our study was to determine whether treatment with a dental implant(s) improve(s) OHRQoL. We created a questionnaire to determine the quality of life before and after implantation. In our study, we evaluated only patients who were treated by the only one implantological system to eliminate the influence of other systems on the quality of the results of the study; we evaluated a total of 297 implants. It was assessed a total of 97...
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Saviano, Raffaele. "La metodica piezoelettrica in chirurgia ossea orale ed implantare. Studio clinico sperimentale in implantologia post-estrattiva immediata." Tesi di dottorato, 2007. http://www.fedoa.unina.it/1684/1/Saviano_Scienze_Odontostomatologiche.pdf.
Повний текст джерела
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Seco, Mariana Soraia Henriques. "Insucessos em implantologia em doentes submetidos a tratamento com Bifosfonatos : estudo de casos clínicos." Master's thesis, 2012. http://hdl.handle.net/10400.14/12055.
Повний текст джерелаАнотація:
Os bifosfonatos (BF) são fármacos que diminuem a actividade osteoclástica sendo utilizados no tratamento de doenças osteodegenerativas tais como a osteoporose, doença de Paget, osteogénese imperfeita e em pacientes oncológicos com metástases ósseas de tumores sólidos e mieloma múltiplo.
Apesar do sucesso dos BF como agentes terapêuticos na redução da morbilidade dos doentes oncológicos, da sua utilização prolongada, advêm diversas complicações, destacando-se o aparecimento de osteonecrose dos maxilares, diagnosticada por Marx, pela primeira vez em 2003.
Assim, a osteonecrose dos maxilares induzida por BF (OMIB) define-se como uma entidade clínica, caracterizada por uma região de osso exposto necrótico, na área maxilofacial, sem resolução entre oito a doze semanas, em doentes tratados com BF, que não fizeram radioterapia da cabeça e pescoço.
A OMIB pode desenvolver-se espontaneamente, contudo está mais frequentemente associada a situações de trauma e a cirurgias invasivas.
Embora a eficácia dos BF no tratamento de diversas patologias seja irrefutável, são ainda necessárias mais pesquisas para a utilização irrestrita dos mesmos na clínica, bem como a terapêutica mais eficaz para obtenção de sucesso clínico. Isto prende-se com o facto dos BF possuírem diversos efeitos adversos, principalmente na cavidade oral.
A colocação de implantes em pacientes sob terapêutica com BF e os seus riscos inerentes, são ainda alvo de debate e controvérsia, não havendo protocolos de actuação específicos que reúnam o consenso da comunidade científica.
A presente monografia visa avaliar os insucessos em implantologia em doentes submetidos a tratamento com BF, procedendo à sua caracterização clínica e à valorização da história clínica e dos novos métodos de diagnóstico bioquímico quer no diagnóstico precoce da OMIB, quer na definição do prognóstico envolvendo a sua evolução e a definição das respectivas abordagens terapêuticas.Foram observadas 2 doentes em terapia com BF, uma das quais submetida a terapia com BF orais e outra que fez terapia com BF endovenosos (BF EV). Ambas desenvolveram OMIB após a colocação de implantes. Foi efectuada a apresentação dos respectivos casos clínicos, a sua discussão baseada na fundamentação teórica e o tratamento aplicado mediante as guidelines existentesBisphosphonates are drugs that decrease osteoclast activity and are used to treat metabolic diseases such as osteoporosis, Paget disease, osteogenesis imperfect and in cancer patients with bone metastases from solid tumors and multiple myeloma. Despite the success of BF as therapeutic agents in reducing the morbility of cancer patients, their prolonged use can lead to several complications, such as the emergence of osteonecrosis of the jaws, diagnosed by Marx for the first time in 2003. Thus the osteonecrosis of the jaws is defined as a clinical entity characterized by a region of necrotic exposed bone in the maxillofacial area, without resolution of eight to twelve weeks in patients treated with bisphosphonates which did not performed radiotherapy of the head and neck. The OMIB may develop spontaneously, but is more often related with trauma situations and invasive surgeries. Although the efficacy of BF in the treatment of various pathologies is irrefutable, more research is still needed for unrestricted use of them in the clinic, as well as the most effective therapy to obtain clinical success. This relates to the fact that they have various adverse effects, particularly in the oral cavity. The placement of implants in patients on therapy with BF and its inherent risks are still the subject of debate and controversy, with no specific action protocols that meet the consensus of the scientific community. This present research aims to evaluate the failures of implants in patients undergoing treatment with BF, as well as the characterization and enhancement of clinical history and new early diagnosis of OMIB. Nevertheless, I have considered also crucial in defining the prognosis, involving the evolution and definition of the therapeutic approaches. In this study were observed in two patients BF therapy, one of which undergoing therapy with oral BF and other therapy did intravenous BF. Both developed OMIB after implants placement. Was made for the relevant clinical cases, their discussion based on theoretical and applied treatment through the existing guideline