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Dissertations / Theses on the topic 'Oral surgery'
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Lundgren, Stefan. "Sedation regimen in outpatient oral surgery." Umeå : Umeå University, 1985. http://books.google.com/books?id=YtBpAAAAMAAJ.
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Bernik, N. V. "Infectious-inflammatory complications in the oral cavity after oral surgery." Thesis, БДМУ, 2021. http://dspace.bsmu.edu.ua:8080/xmlui/handle/123456789/19116.
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Vijayakumar, Charanya. "Bioactive glasses in cranio-maxillofacial and oral surgery." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2012. http://hub.hku.hk/bib/B48542118.
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Lau, Sze-lok Alfred. "Evidence-based practice in oral and maxillofacial surgery /." View the Table of Contents & Abstract, 2005. http://sunzi.lib.hku.hk/hkuto/record/B32222154.
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Lau, Sze-lok Alfred, and 劉思樂. "Evidence-based practice in oral and maxillofacial surgery." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2005. http://hub.hku.hk/bib/B45007755.
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Ferri, Connie L. "Alteration in vowel production following surgery for oral cancer." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk2/tape17/PQDD_0002/MQ30734.pdf.
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Hanson, Christine Joan. "Clinical competency in oral surgery : history, challenges and solutions." Thesis, University of Dundee, 2015. https://discovery.dundee.ac.uk/en/studentTheses/71eba1df-fc6e-4418-ba06-3c3d829d1448.
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This multifaceted study documents validates, and verifies the changes in oral surgery teaching in Dundee University Dental School, which have changed with time to accommodate the demands of an ever increasingly complex discipline. Availability of instructive teaching material in hard copy and as video and text on the internet combined with close clinical supervision and detailed assessment with feedback allows students to attain competency in exodontia with falling patient numbers. It has been demonstrated that the undergraduate training in the oral surgery clinics still attains competency or BDS standard of ‘safe beginner’ for simple extractions and minor oral surgery, despite fewer procedures being carried out. The criteria used for undergraduate assessment and marking of exodontia have been validated in house and nationally. These are appropriate, objective and reliable. Using Thiel cadavers is a valid and reliable method of teaching undergraduate students the technique of extraction with forceps prior to their clinical exposure. Further employment of the cadavers for continuing practice and the introduction of new skills has been mooted. The use of the ‘Blackboard’ was investigated and found not to be well used; the effort to produce the work was not well directed since it was not taken advantage of by the whole year nor very frequently by those who do use it. Alternative methods of engaging the student to investigate and research the discipline have been suggested. Encouragement of the students to interact more when the exodontia clinic time is available for this opportunity has been introduced and suggestions to increase this activity to enhance the teaching of core topics have been made. From apprehension to enjoyment our student assure us that they find this discipline worthwhile whilst acknowledging that it will not be a practice builder and that they are equipped to deal with simple oral surgery procedures.
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GABRIELE, GUIDO, PIETRO NAVALESI, and CALOGERO MARIA ODDO. "experimental evaluation of tactile sensors for oral and maxillofacial surgery." Doctoral thesis, Università di Siena, 2023. https://hdl.handle.net/11365/1225926.
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The sense of touch is fundamental in surgery. It provides information about the clinical condition of tissues and feedback for controlling surgical gestures. In the last decade the use of sophisticated and low-invasive surgical techniques has limited the interaction of surgeons via their own hands. In fact the introduction of laparoscopic, endoscopic and robotic surgery has reduced the invasiveness of procedures of but also the possibility of direct control and palpation. Despite the clinical evidence on the advantages and added value of such new surgical technologies, the lack of tactile interaction remains a limiting factor. The role of tactile information concerns sensing, for example, the pressure necessary to incise a tissue or to tighten the knot of a suture or the palpation of an anatomical structure. Traditionally, tactile information is received by the own hand of the operator or through the surgical instrumentation. In fact, palpation using hands has always been a prominent part of the objective examination, allowing the physician to determine the location of pathological conditions that escape sight. In addition, it also provides information about extension, consistency and pain of hidden pathologies. Each tissue has its own tactile peculiarities as well as each procedure requires specific tool-tissue interaction. Errors in a surgical procedure due to the lack of tactile information or inadequate tool-tissue interaction forces are common and, therefore, acquiring this kind of knowledge is paramount to enhance surgical performance and education.
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LOMBARDI, NICCOLO' GIANCESARE. "SURGICAL TREATMENT OF ORAL LEUKOPLAKIA: A RANDOMIZED CONTROLLED CLINICAL TRIAL COMPARING SURGERY WITH WAIT AND SEE APPROACH." Doctoral thesis, Università degli Studi di Milano, 2022. https://hdl.handle.net/2434/945285.
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Rationale of the study: Different treatments have been proposed for the management of the most common oral potentially malignant disorders (i.e., leukoplakia and erythroleukoplakia) in order to prevent the risk of oral cancer. However, there is currently no consensus on the most effective approach for the patients affected by such lesions. Surgery is often performed, but in literature there is no randomized clinical trial that demonstrates its real effectiveness in preventing malignant transformation.
Objective: To compare the incidence of oral squamous cell carcinoma (OSCC) in a group of subjects undergoing surgical treatment and a similar group under strict clinical and histological surveillance (“wait and see” approach). To evaluate the long-term recurrence rate in test group after surgical excision of the oral leukoplakia.
Study Design: Multicentric randomized controlled clinical trial (RCT).
Setting: Unit of Oral Medicine - ASST Santi Paolo e Carlo Milano - Head and Neck Department San Paolo Hospital of Milan - Università degli Studi di Milano - Reference Center of the study; Unit of Oral and Medicine and Oncology - CIR Dental School of Turin - Università degli Studi di Torino
Patients and Method: Inclusion criteria: adult patients to whom, after an incisional diagnostic biopsy, have been diagnosed an oral leukoplakia or erythroplakia. Exclusion criteria: patients affected by a previous oral cancer, patients under the age of 18, pregnant patients, patients affected by PVL, lesions located in anatomical risk areas in which the excision may cause post-surgical deficit (salivary ducts, nerves, arteries…) and lesions more extensive than 3cm.
Patients included in the study are divided into two groups: surgery (test group) and wait and see (control group). The randomization has been created using an online tool.
Demographics data, habits, clinical information are collected for both groups. Technique of excision, surgical margins, recurrence and intra and post-surgical complications, are collected in the test group, while clinical and histopathological changes are collected in the control group.
Outcomes Primary: oral cancer incidence Secondary: time to malignant progression from diagnosis, recurrence rate in test group.
Conclusion and clinical relevance: This study will compare surgical treatment with “wait and see” approach in order to evaluate the real effectiveness of surgery in preventing and reducing oral cancer incidence in a group of subjects affected by oral leukoplakia. This study will contribute to determine which is the most appropriate management for such patients and to establish a gold-standard treatment.
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Albittar, Mohammed [Verfasser]. "Prophylaxis of infective endocarditis in oral and maxillofacial surgery / Mohammed Albittar." Ulm : Universität Ulm, 2021. http://d-nb.info/1233737503/34.
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Muniz, Rosina Maria Carvalho Caminha. "Oral conditions and Streptococcus mutans isolation in patients undergoing bariatric surgery." Universidade Federal do CearÃ, 2011. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=7122.
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nÃo hÃIntroduction: Obesity is associated with oral diseases by promoting inflammatory processes and because of the fact that obese patients often eat cariogenic foods and use drugs capable of inducing salivary alterations. Bariatric surgery, surgical means of treating morbid obesity and obesity associated to co-morbidities, aims to change the volumetric capacity of the gastrointestinal tract and the course of the alimentary bolus. It causes changes in food consumption patterns and, often, gastro-esophageal disorders and may influence deleteriously oral health, which, however, is not determined. Objective: The aim of this study was to determine the profile of drug use, the occurrence of vomiting and tooth sensitivity, the standard of food eating and dental plaque index; to quantify Streptococcus mutans in stimulated saliva; to measure DMFT and to count erosive lesions in patients who had already been submitted to bariatric surgery and in patients who were going to be submitted to bariatric surgery, registering changes in pattern of occurrence of vomiting and tooth sensitivity and dietary patterns of patients who had already been submited to bariatric surgery. Materials and Methods: Through cross-sectional study, seeking retrospective data, there were evaluated 46 patients undergoing bariatric surgery (âNon-Operatedâ group) and 46 in the second year of postoperative follow-up of the same surgery (âOperatedâ group). After collection of personal data, we proceeded to collect saliva (to quantify S. mutans) and dental evaluation. Results: "Non-operated" group showed greater medication use and lower frequency of vomiting than "Operatedâ group, although, in this group, the occurrence of vomiting had reduced over time. "Operated" group had a higher intake of sweet foods and smaller intake of acid food than "Non-operatedâ group; the consumption of sweet foods and red meat of âOperatedâ group at the time of assessment decreased compared the preoperative period. Both groups had similar dental sensitivities and the majority of "Operated" group patients reported similarity of tooth sensitivity after surgery compared to preoperative values. Both groups showed similar and high plaque index (52.03 Â 14.30 for "Non-operated" group and 51.59 Â 10.38 for "Operatedâ group), the same was observed for S. mutans count (log (number of CFUs per mL of saliva +1) equal to 5.12 Â 0.64 for "Non-operated" group and 5.05 Â 1.06 for "Operated" group) and DMTF (13.67 Â 5.78 for "Non-operated" group 13.33 Â 5.78 for "Operated" group). Both groups were similar with respect to dental erosion variable. Discussion: Elevated plaque index, S. mutans count and DMFT show the condition of poor oral health of both patients with morbid obesity and submited to bariatric surgery, difficulting the eventually possible weight loss process by clinical means for obese patients and burdening the "new stomach" in patients undergoing surgery. Conclusion: Bariatric patient needs more attention to oral health, from oral hygiene orientation to the performance of operative procedures, providing oral health and contributing to the success of the surgical procedure.
IntroduÃÃo: A obesidade està associada a alteraÃÃes bucais, por favorecer processos inflamatÃrios e pelo fato de pacientes obesos ingerirem frequentemente alimentos cariogÃnicos e utilizarem fÃrmacos capazes de induzir alteraÃÃes salivares. A cirurgia bariÃtrica, meio cirÃrgico de tratar a obesidade mÃrbida e a obesidade associada a co-morbidades, visa alterar a capacidade volumÃtrica do trato gastrointestinal e o curso do bolo alimentar. Ocasiona alteraÃÃo do padrÃo alimentar e, nÃo raro, transtornos gastro-esofÃgicos, podendo influenciar deleteriamente a saÃde oral, o que, entretanto, nÃo està determinado. Objetivo: Determinar o perfil de uso de medicamentos, a ocorrÃncia de vÃmito e de sensibilidade dental, o padrÃo alimentar e o Ãndice de placa dental; quantificar Streptococcus mutans em saliva estimulada; medir CPOD e contar lesÃes erosivas em pacientes submetidos e a serem submetidos à cirurgia bariÃtrica; registrar alteraÃÃes em padrÃo de ocorrÃncia de vÃmito e sensibilidade dental e em padrÃo alimentar de pacientes submetidos à cirurgia bariÃtrica. Materiais e mÃtodos: Mediante estudo transversal observacional, buscando dados retrospectivos, avaliaram-se 46 pacientes a serem submetidos à cirurgia bariÃtrica (Grupo âNÃo-Operadoâ) e 46 no segundo ano de acompanhamento pÃs-operatÃrio da mesma cirurgia (Grupo âOperadoâ). ApÃs coleta de dados pessoais, procedeu-se à coleta de saliva (a fim de quantificar de S. mutans) e à avaliaÃÃo odontolÃgica. Resultados: O grupo âNÃo-operadoâ apresentou maior uso de medicamentos e menor frequÃncia de vÃmito do que o grupo âOperadoâ; apesar de, neste, ter havido reduÃÃo da ocorrÃncia de vÃmito com o passar do tempo. O grupo âOperadoâ apresentou maior ingestÃo de alimentos doces e menor ingestÃo de alimentos Ãcidos do que o grupo âNÃo-operadoâ; o grupo âOperadoâ apresentou reduÃÃo do consumo de alimentos doces, Ãcidos e carne vermelha no momento da avaliaÃÃo em comparaÃÃo ao perÃodo prÃ-operatÃrio. Os grupos apresentaram sensibilidades dentais semelhantes e a maioria dos pacientes do grupo âOperadoâ relatou similitude de sensibilidade dental no pÃs-operatÃrio em relaÃÃo ao prÃ-operatÃrio. Os grupos apresentaram Ãndices de placa elevados (52,03  14,30 para o grupo âNÃo-operadoâ e 51,59Â10,38 para o grupo âOperadoâ) e semelhantes; o mesmo tendo sido verificado para a contagem de S. mutans (log(nÃmero de UFCs por mL de saliva+1) igual a 5,12  0,64 para o grupo âNÃo-operadoâ e a 5,05  1,06 para o grupo âOperadoâ) e para CPOD (13,67  5,78 para o grupo âNÃo-operadoâ 13,33  5,78 para o grupo âOperadoâ). Os grupos mostraram-se semelhantes com relaÃÃo à variÃvel erosÃo dental. DiscussÃo: Os valores elevados de Ãndice de placa, contagem de S. mutans e CPOD demonstram a condiÃÃo inadequada de saÃde bucal tanto de pacientes obesos mÃrbidos quanto submetidos à cirurgia bariÃtrica, dificultando o processo de emagrecimento por meios clÃnicos eventualmente possÃvel do paciente obeso e sobrecarregando o ânovo estÃmagoâ no paciente operado. ConclusÃo: O paciente bariÃtrico necessita maior atenÃÃo à saÃde bucal, desde a orientaÃÃo de higiene bucal atà a realizaÃÃo de procedimentos operatÃrios, viabilizando a saÃde bucal e contribuindo para o Ãxito do procedimento cirÃrgico.
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Jones, Hannah F. "The oral health of people with serious mental illness." Thesis, University of Nottingham, 2016. http://eprints.nottingham.ac.uk/32720/.
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The physical health needs of people with serious mental illness have been neglected for a long time (1), this has initiated the development of guidelines and recommendations from the British Society for Disability and Oral Health (BSDH) for the oral health care for people with serious mental illness (2). Guidelines recommend monitoring and advice and although they are well meaning, randomised controlled trial evidence to support the recommendations is missing (3, 4). Cochrane systematic reviews found no randomised controlled trials of oral health advice or monitoring for people with serious mental illness (5). A Cochrane systematic review of general physical health advice interventions for people with serious mental illness (6) found evidence to suggest such interventions could lead to people accessing more health services. For oral health there is some survey evidence to suggest regular dental check-ups have been found to be associated with better oral health (7), so if a monitoring and advice intervention can influence someone with serious mental illness to visit a dentist this may in turn improve their oral health. A systematic review of 55 studies examining the prevalence of poor oral health and hygiene practices, dental treatment needs, and dental attendance of people with serious mental illness, was conducted to assess the extent to which people with serious mental illness brush their teeth and attend dental appointments. The majority of participants did not practice good oral hygiene, and were more likely not to have seen a dentist for a longer period of time than the general population. Those with serious mental illness also had more decayed teeth, more missing teeth, but fewer filled teeth, than the general population. Most of those with mental illness required some form of dental treatment ranging from oral hygiene instruction to complex dental treatment for those with shallow pockets or deep pockets in their teeth. A narrative review of the knowledge and attitudes regarding oral health in populations with serious mental illness from service users, and mental health and dental professionals’ perspectives found that individuals with serious mental illness were more likely to have poor oral health due to neglecting their oral hygiene and because they did not attend regular dental appointments. Previous negative experiences at dental appointments or general dental anxiety prevented individuals with a mental illness from seeking help until they experienced a dental emergency. The majority of service users reported that support from mental health nurses was helpful, even though nurses tended to report feeling unconfident and inadequately trained to provide this care. A systematic review of randomised controlled trials of interventions for improving the oral health of people with serious mental illness identified four studies which all had such varied interventions and measured different outcomes that combining them in a meta-analysis was not possible. Providing toothbrushes appeared to improve the oral health of people with serious mental illness. Some of the interventions involved an education element which also significantly improved oral health. A pragmatic cluster randomised controlled trial of an oral health intervention for people with serious mental illness involved 1074 service users from the Early Intervention in Psychosis teams in the East Midlands of England being randomised either to receive a dental intervention or standard care. The dental intervention involved completing a checklist with their Care Co-ordinator concerning their oral health and oral hygiene behaviour and the standard care simply involved continuing with standard care for 12 months before then completing the checklist. At baseline only 271/550 service users randomised to the dental intervention group completed dental checklists. Only 98/271 (36.1%) of service users returned a completed dental checklist at the 12 month follow up and for those allocated to standard care 91/524 (17%) returned a completed dental checklist at the 12 month follow up. The checklist did not improve oral health behaviour in people with serious mental illness. The oral health of people with serious mental illness remains a vastly under researched area. Mental health professionals should receive training to improve their oral health care knowledge. Mental health professionals should also provide advice to their patients regarding their oral health, monitor oral health as part of standard care and support patients to attend regular dental check-ups. An effective intervention that can be used within standard care could significantly improve the quality of life for people with serious mental illness.
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Gallagher, J. E. "A health futures study of facial, oral and dental surgery in London." Thesis, King's College London (University of London), 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.399299.
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Stanford, Penelope Denise. "The management of postoperative pain in oral and maxillofacial and ophthalmic surgery." Thesis, University of Manchester, 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.698186.
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Josefsson, Kenneth. "Antimicrobial prophylaxis of bacteraemia in oral surgery pharmacological, toxicological and microbiological aspects /." Stockholm : Dept. of Oral Surgery, Karolinska Institutet, 1985. http://catalog.hathitrust.org/api/volumes/oclc/12018190.html.
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CHAUDHRY, SAMRA. "Psychological & Pain-related constructs in Endodontic and Minor Oral Surgery Patients." Thesis, The University of Sydney, 2021. https://hdl.handle.net/2123/25852.
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The presence of pre-operative pain and some psychological factors, such as fear of pain, pain catastrophizing and anxiety could serve as predictors for the future development of acute pain and the transition from acute to persistent pain. The 1st study aim was to investigate if there were any significant differences in the pre and post-treatment pain intensities and psychological characteristics of endodontics and minor oral surgery patients. The 2nd aim was to investigate whether the psychological characteristics and pain intensities of those patients who suffer from post-treatment pain (PTP) differ significantly from those with no post-treatment pain (NPTP).
50 patients requiring endodontic or minor oral surgery treatment were recruited from the Westmead Centre of Oral Health, Westmead Hospital. The pre-treatment protocol required the participants to complete a Battery of Questionnaires (containing FPQ III, MPQ, PCS, STAI and NPQ) along with a 1-week pain diary containing a VAS for pain. At 1-week post-treatment, participants were requested to complete the same questionnaires and 2 additional weeks of the pain diary.
Data analysis of the 34 participants who completed the study revealed significant differences between the pre and post-treatment time points only in the total PCS score, the ‘severe’ subscale of FPQ III and in trait anxiety. A comparison of the PTP and the NPTP participants revealed no significant differences in the pre-treatment pain intensities and the pre and post-treatment psychological characteristics between the groups.
The non-significant differences between the PTP and the NPTP participants could mainly be explained by the inter-individual variability in the pain experience and the biopsychosocial model of pain which emphasizes that the unique experience of pain is the result of the complex dynamic interactions of the biological, psychological and social factors. The role of social stressors was not part of this study.
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Bodin, Ingrid. "Impairment of intra-oral sensation, discrimination ability, and swallowing function following radiotherapy and surgery for oral and pharyngeal cancer." Doctoral thesis, Umeå : Univ, 2004. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-266.
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Ljunggren, Stefan, and Robert G. Hahn. "Oral nutrition or water loading before hip replacement surgery; a randomized clinical trial." Linköpings universitet, Anestesiologi med intensivvård, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-84540.
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Background Surgery induces insulin resistance that might be alleviated by a nutritional drink given preoperatively. The authors hypothesized that some of the beneficial effects of the drink could be attributed to the volume component (approximately 1 L) rather than to the nutrients. Methods Sixty patients scheduled for elective total hip replacement under spinal anesthesia were recruited to a clinical trial, and randomly allocated to preoperative fasting, to oral ingestion of tap water, or to oral ingestion of a carbohydrate drink. An intravenous glucose tolerance test calculated glucose clearance and insulin sensitivity on the day before surgery, in the postoperative ward, and on the day after surgery. Other parameters were stress (cortisol in plasma and urine), muscle catabolism (urinary 3-methylhistidine), and wellbeing. Results Fifty-seven patients completed the study. In the postoperative ward, the glucose clearance and the insulin response had decreased from the previous day by 23% and 36%, respectively. Insulin sensitivity did not decrease until the next morning (−48%) and was due to an increased insulin response (+51%). Cortisol excretion was highest on the day of surgery, while 3-methylhistidine increased 1 day later. Follow-up on the third postoperative day showed an average of 1.5 complications per patient. Wellbeing was better 2 weeks after than before the surgery. None of the measured parameters differed significantly between the study groups. Conclusions Preoperative ingestion of tap water or a nutritional drink had no statistically significant effect on glucose clearance, insulin sensitivity, postoperative complications, or wellbeing in patients undergoing elective hip surgery.Funding Agencies|Olle Engkvist Byggmastare Foundation||Stockholm County Council|2009-0433|
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Röing, Marta. "Understanding Oral Cancer - A Lifeworld Approach." Doctoral thesis, Uppsala University, Department of Surgical Sciences, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-8284.
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Dental involvement with oral cancer patients during their treatment and rehabilitation can be long and intense. How can dental personnel better understand their role in the treatment of these patients? How does treatment affect the patients and their spouses? In searching for answers, the theories of phenomenography, phenomenology and hermeneutics are used to describe and interpret the experiences of the hospital dental treatment teams, oral cancer patients, and their spouses.
Study I reveals that hospital dental treatment teams perceive the encounter with head and neck cancer patients in three qualitatively different ways; as an act of caring, as a serious and responsible task, and as an overwhelming emotional situation, indicating that they are not always able to lean on education and professional training in dealing with situations with strong emotional impact. Study II gives insight into the lifeworld of oral cancer patients, and how the patient becomes embodied in a mouth that is increasingly `uncanny´, as it slowly ceases to function normally. Study III shows that oral cancer puts a hold on the lifeworld of the patients’ spouses which can be described as `living in a state of suspension´. These findings suggest that the support needs of patients and spouses appear to be greatest at treatment end, when, upon returning home, they are faced with the accumulated impact of the patients’ sickness and treatment. Study IV gives insight into what it may mean to live with the consequences of oral cancer, revealing a silent physical, emotional and existential struggle to adjust to a changed way of living.
This thesis raises the question if todays’ organisation of oral cancer care can meet the varying emotional and existential needs of treatment teams, patients and spouses that were brought to light.
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Nafea, Ebtihaj. "Clinical reasoning in dental students : a comparative cross-curricula study." Thesis, University of Nottingham, 2015. http://eprints.nottingham.ac.uk/30395/.
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Clinical reasoning is a skill required by all health professionals in managing patients. Research in clinical reasoning has come mostly from medicine and nursing, less from dentistry. The effect of curriculum on the development of clinical reasoning is still not well understood. Moreover, no research has been conducted to understand what clinical reasoning means to students and what educational strategies are valued by them. The aim of this research is to explore the effect of different educational strategies in different dental schools on clinical reasoning and to discover how students perceive clinical reasoning. Final year students from four different dental schools participated in the current research; a school using an integrated curriculum with conventional teaching, a school using Problem Based Learning (both from the UK) and two Saudi Arabian dental schools; a school using a traditional curriculum and a school using an integrated curriculum. Both UK schools participated in both studies, whereas each one of the Saudi Arabian schools participated in a different study. The research used both quantitative and qualitative methodology. An innovative clinical reasoning test measured final year students’ skills. An interview captured their own understanding of clinical reasoning and its acquisition plus they ‘talked through’ a clinical problem, using a ‘think aloud’ technique. Thematic analysis was used to analyse the transcripts of the recorded interviews. Results obtained were related to curriculum structure. The results indicated that the effect of curriculum structure, unlike teaching and assessment strategies, appeared to be minimal in final year students. Unfamiliarity with the term clinical reasoning was common in students. Students from different schools used different strategies to reason when discussing clinical vignettes. Different behaviours seemed to be affected by cultural factors. This research contributes to a greater understanding of how students learn, understand and apply dental clinical reasoning which hopefully will improve educational practices in the future.
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Montini, Reid W. "Perceptions of orthognathic surgery patients' change in profile a five year follow-up /." [Gainesville, Fla.] : University of Florida, 2005. http://purl.fcla.edu/fcla/etd/UFE0010492.
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Thesis (M.S.)--University of Florida, 2005.Typescript. Title from title page of source document. Document formatted into pages; contains 30 pages. Includes Vita. Includes bibliographical references.
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Matthews, April. "The use of salivary biomarkers in the detection of oral squamous cell carcinoma." Thesis, University of Liverpool, 2015. http://livrepository.liverpool.ac.uk/2025699/.
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Background: Oral squamous cell carcinoma (OSCC) is the 15th most common cancer worldwide but has poor five year survival (50%). Late stage presentation and limitations of early diagnostic techniques are persistent clinical problems. Sixty percent of patients present with advanced stage disease and with the attendant increase in mortality, morbidity and risk of recurrent disease it is particularly burdensome for both patients and health economies. Early diagnosis and treatment of OSCC improves prognosis. There is an opportunity to diagnose OSCC early in patients with oral epithelial dysplasia however currently there is no way of accurately predicting which lesions will undergo malignant transformation. Aberrant methylation of tumour suppressor genes plays a significant role in the biology of early cancer and is detectable in both tumour and saliva. Saliva is a non-invasive method of longitudinal sampling and has potential as a tumour surrogate in disease surveillance programmes. This study aims to compare rates of methylation of a panel of genes in OSCC patients and a normal cohort to establish a threshold by which we could determine future disease testing in a dysplastic population. Methods: Saliva samples were collected from 219 individuals from three diagnostic groups: Normal (defined as no oral malignant or premalignant disease) n=97, OSCC n=62 and dysplasia n=60. For statistical analysis the dysplasia cohort was sub-divided into lesions of low and high risk of malignant transformation based on the histological diagnosis of the index lesion. DNA was extracted and bisulphite treated from 258 saliva samples before duplex quantitative methylation specific PCR (qMSP) assays were performed on all samples to detect the frequency of methylation in saliva of a panel of genes. The five target genes (ADAMTS9, CCNA1, CYGB, P16, TMEFF2) were selected using a candidate approach on the basis of tumour specificity from studies on tumour/normal matched tissue pairs. Clinicopathological data was correlated with the qMSP data and analysed using SPSS v.21 statistical software to look for associations with tumour and survival characteristics. Results: Only 3/97 individuals from the control normal cohort had saliva samples with detectable methylation above the analytical sensitivity of the P16 assay. Methylation of the remaining target genes (ADAMTS9, CCNA1, CYGB, TMEFF2) was not detected in normal saliva at levels above the analytical sensitivity of the qMSP assays. The most significant finding in this study was that methylation of four of the target genes (CCNA1, CYGB, P16, TMEFF2) in saliva, individually and when considered as a panel, was significantly associated with OSCC and as such could aid discrimination between malignant disease and normal saliva samples. Methylation of at least one gene in the panel was discovered in 29/67 of the binned OSCC saliva samples but only 3/97 of normal samples (Fisher’s exact p=0.001). Furthermore methylation of the gene panel is associated with high risk lesions when detected in saliva of patients with premalignant lesions (Fisher’s exact p=0.03). Conclusions: This exploratory data supports the utility of duplex qMSP as a detection method for methylation markers in saliva. The detection of methylation of this gene panel in saliva is significantly more associated with oral malignancy and high risk premalignant lesions than normal and low risk disease. This implies saliva may have merit as a surrogate tissue in an adjunctive role to clinical assessment and biopsy. The assays are specific but have limited sensitivity. However with further work, inclusive of additional genes, this methodology may identify predictive biomarkers that can be introduced into a trial surveillance of premalignant lesions.
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Milani, Basilio de Almeida. "Avaliação clínica da eficácia da amoxilina ministrada em múltiplas doses no pós-operatório de exodontias de terceiros molares inferiores." Universidade de São Paulo, 2012. http://www.teses.usp.br/teses/disponiveis/23/23147/tde-06032012-171226/.
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O uso de antibióticos para reduzir a infecção pós-operatória em cirurgia de terceiro molar permanece controverso. O objetivo deste estudo foi avaliar a eficácia da terapêutica com Amoxicilina em múltiplas doses para a prevenção de infecção em pacientes submetidos à extração de terceiro molar inferior com posição 2B (classificação de Pell & Gregory). O estudo foi prospectivo, cego, randomizado, duplo, controlado por placebo, com 32 pacientes. Cada paciente atuou como seu próprio controle usando a técnica de boca dividida. Um terceiro molar inferior foi retirado sob a cobertura de antibióticos no pós-operatório (500 mg de amoxicilina a cada 8 horas durante 7 dias) e o outro foi removido sem cobertura antibiótica pós-operatória (cápsulas de placebo a cada 8 horas durante 7 dias), mas em ambas cirurgias foi administrada dose única no pré-operatório de 1 g de amoxicilina. Os seguintes parâmetros foram avaliados no pré-operatório, no quarto e sétimo dias pós-operatórios: trismo, edema facial, temperatura corporal, linfadenopatia, infecção, disfagia e dor. Não houve diferença estatisticamente significativa nos parâmetros avaliados entre os pacientes operados (p> 0,05). Resultado do estudo mostrou que a administração de amoxicilina em dose única pré-operatória e em doses múltiplas pós-operatórias não se mostrou mais eficaz do que a administração somente em dose única pré-operatória com relação aos parâmetros clínicos avaliados nas exodontias de terceiros molares inferiores.The use of antibiotics to reduce postoperative infection in third molar surgery remains controversial. The goal of this study was to evaluate the efficacy of multi-dose Amoxicilina therapy for the prevention of infection in patients undergoing lower third molar extraction with position 2B (Pell & Gregory classification). The study was a prospective, randomized, double blind, placebo-controlled trial with 32 patients. Each patient acted as their own control using the split-mouth technique. One lower third molar were removed under antibiotic cover postoperative (500 mg amoxicillin 8 hourly for 7 days) and the other were removed without antibiotic cover postoperative (placebo capsules 8 hourly for 7 days), but both surgery was administered preoperatively single dose of 1g of amoxicillin. The following parameters were evaluated on the preoperative and fourth, seventh days postoperative: trismus, facial swelling, body temperature, Lymphadenopathy, infection, dysphagia and pain. There was no statistically significant difference in the parameters evaluated between patients operated (p > 0.05). Results of the study showed that administration of amoxicillin single dose preoperative and postoperative multiple doses was not more effective than single dose administration only pre-operative with respect to clinical parameters evaluated in the lower third molar extractions.
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Badenoch-Jones, Emma K. "Consent for third molar tooth extractions." Thesis, Queensland University of Technology, 2018. https://eprints.qut.edu.au/123066/1/Emma_Badenoch-Jones_Thesis.pdf.
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This project is an important contribution to the field of medico-legal practice in surgery. The thesis provides perspectives in deficient areas of objective evidence on consent for third molar tooth extractions through defined patient and judicial disclosures and understanding. The outcome of the project is an evidence-based consent form for third molar tooth extractions that will enhance the standard of patient information disclosure for this procedure by general dentists and oral and maxillofacial surgeons. The methodological process adopted is also one that can be replicated in other medical fields to yield objective evidence to guide the process of consent for any medical procedure.
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Saleh, Gadier, and Noura Rassa. "Självupplevd oral hälsa hos gastric bypass-opererade individer." Thesis, Högskolan Kristianstad, Avdelningen för oral hälsa, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:hkr:diva-21941.
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Syftet med denna studie var att undersöka hur gastric bypass-opererade individer upplever sin orala hälsa efter kirurgin. En empirisk studie med en kvalitativ ansats genomfördes. Datainsamlingen som användes var semistrukturerade intervjuer med en intervjuguide som underlag. Urvalet bestod av åtta informanter i åldrarna 24–64 och som valdes genom ett snöbollsurval. En kvalitativ innehållsanalys användes för att analysera intervjuerna. Resultatet redovisas utifrån temat Förändringar efter gastric bypass-operation relaterat till oral hälsa. Informanterna upplevde att de fått erosionsskador, karies, muntorrhet, oral halitosis och parodontala problem postoperativt. Samtliga informanter upplevde en försämrad allmänhälsa efter operationen och förändrade kostvanor som innebar att de började äta regelbundna måltider med korta tidsintervall. Slutsatsen av studien visar att informanterna upplevde en försämrad oral hälsa efter gastric bypass-operationen, där erosionsskador, karies, muntorrhet, oral halitosis och parodontala problem angavs till följd av de förändrade kostvanorna samt den påverkan på den allmänna hälsan som uppstod till följd av operationen.
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Forgie, Melissa Anne. "Duration of oral anticoagulation in first-episode idiopathic deep vein thrombosis: A Markov decision analysis." Thesis, University of Ottawa (Canada), 2001. http://hdl.handle.net/10393/9288.
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Deep venous thrombosis (DVT) of the lower extremity is a serious illness with an estimated incidence of 1 per 1000 persons per year. Objectives. To compare the lifetime risks and benefits of three months, six months, twelve months, two years, and lifelong anticoagulation for first episode idiopathic DVT. Secondary objectives were to assess quality of life for patients on warfarin therapy for DVT and for patients with post-thrombosic syndrome. A third objective was to determine if quality of life for these two health states differed between patients and healthy volunteers. Methods. Decision analysis with a Markov model was used to simulate patients with first episode idiopathic DVT who would be treated with durations of therapy ranging from three months to lifelong. The probabilities of clinical events were extracted from a systematic review of the literature on duration of therapy for DVT as well as rates of bleeding secondary to anticoagulant therapy and rates of developing post-thrombotic syndrome. Utilities for each of the associated health outcomes were elicited from patients and healthy volunteers using a computerized interview. (Abstract shortened by UMI.)
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Cattaneo, Maurizio Vittorio. "The potential of microencapsulated urease-zeolite oral sorbent for the removal of urea in uraemia /." Thesis, McGill University, 1989. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=74273.
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Oral sorbent therapy, as an adjunct or a replacement for dialysis therapy, is one area of research with great potential. If successful it can help kidney failure patients avoid a "life on the machine" existence. For the past twenty years the major problem was in finding an effective oral sorbent for urea. The use of oral microcapsules containing a urease-silica adduct and ion exchanger zirconium phosphate, though successful in reducing urea levels, resulted in a number of problems including a negative calcium balance. In this thesis it is demonstrated that the use of microcapsules containing a urease-zeolite preparation may be a potential route to urea removal. The use of zeolite ion exchangers, and zeolite W in particular, can alleviate the above mentioned problems of zirconium phosphate. In addition, the use of enzyme envelopes on zeolite support, which replaces silica, can reduce the amount of ingested material by at least 25%. The present "in vitro" study shows that the microcapsules remove up to 80% of urea in less than one hour. Preliminary "in vivo" experiments on Sprague-Dawley uraemic rats treated with ingested microcapsules indicate reductions in urea level and a lengthening of survival times compared to controls.
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Porto, Ana Laryssa Ferreira Gomes. "AvaliaÃÃo comparativa do uso prà ou pÃs-operatÃrio de amoxicilina em exodontias simples realizadas em pacientes portadores de artrite reumatoide tratados com inibidores de fator de necrose tumoral alfa e/ou metotrexato." Universidade Federal do CearÃ, 2015. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=14953.
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A artrite reumatoide (AR) Ã uma condiÃÃo autoimune caracterizada por uma inflamaÃÃo das articulaÃÃes. As medicaÃÃes mais utilizadas no tratamento da AR sÃo drogas antireumÃticas modificadoras da doenÃa (DMARD), como o metotrexato (MTX) e agentes biolÃgicos, dentre estes os inibidores do fator de necrose tumoral alfa (anti-TNF-α). Trabalhos recentes relacionam estes fÃrmacos a um maior acometimento de infecÃÃes. O objetivo do estudo foi avaliar a ocorrÃncia de inflamaÃÃo, dor, cicatrizaÃÃo e presenÃa de infecÃÃes apÃs exodontias em pacientes com AR sob tratamento com anti-TNF-α e MTX que fizeram uso prÃ-operatÃrio ou pÃs-operatÃrio de amoxicilina. Os pacientes com AR foram distribuÃdos, de forma randÃmica, em dois grupos: grupo A (profilaxia antibiÃtica â utilizaram 4 cÃpsulas de 500mg de amoxicilina uma hora antes do procedimento) e grupo B (cobertura antibiÃtica- fizeram uso de uma cÃpsula de 500mg de amoxicilina de 8 em 8 horas por 5 dias). AlÃm desses, para fins de controle, um terceiro grupo foi formado por pacientes sem AR e sem prescriÃÃo de antibiÃticos. ApÃs avaliaÃÃo de exames hematolÃgicos e radiogrÃficos, foram realizadas 30 exodontias (13 pacientes com AR e 12 do grupo controle) por um mesmo operador nos 3 grupos. Esse operador, assim como os pacientes dos grupos A e B, desconhecia qual esquema de medicaÃÃo empregada. AvaliaÃÃes periÃdicas (24 horas, 72 horas, 7 dias, 14 dias e 30 dias apÃs o procedimento) foram feitas para identificar sinais clÃnicos e radiogrÃficos de infecÃÃo e de inflamaÃÃo. A avaliaÃÃo da cicatrizaÃÃo da ferida cirÃrgica foi feita atravÃs de mediÃÃes com um paquÃmetro nos intervalos de 24 horas, 72 horas, 7 dias e 14 dias. Para verificaÃÃo da sintomatologia dolorosa, utilizou-se uma escala visual analÃgica (VAS) que foi entregue aos pacientes apÃs a exodontia. Todos os pacientes fizeram 3 radiografias periapicais (antes da exodontia, com 24 horas e apÃs 30 dias) que foram digitalizadas e analisadas pelo software ImageJÂ com intuito de verificar o perÃodo cicatricial radiogrÃfico por meio da modificaÃÃo da Ãrea radiolÃcida alveolar. A maioria dos pacientes participantes foi mulheres, tanto no grupo controle (58,3%) quanto nos grupos A e B (83,3% e 100% respectivamente). Os nÃveis de plaquetas dos pacientes dos grupos A e B foram superiores aos do grupo controle (p=0,008). No que se refere aos sinais inflamatÃrios e de infecÃÃo, nÃo houve diferenÃa significativa entre os trÃs grupos, assim como nos Ãndices de dor e na cicatrizaÃÃo Ãssea avaliada radiograficamente, diferentemente dos Ãndices de cicatrizaÃÃo tecidual, onde os grupos A e B apresentaram menores Ãreas das feridas cirÃrgicas e melhor contraÃÃo das feridas que o grupo controle (p=0,005). Os pacientes dos grupos A e B apresentaram reparo Ãsseo, Ãndice de inflamaÃÃo e de infecÃÃo semelhantes ao grupo controle, entretanto, os parÃmetros de cicatrizaÃÃo tecidual nos grupos A e B foram superiores quando comparados ao grupo controle. Com isso, sugere-se que o uso da amoxicilina de forma profilÃtica seja o mais adequado e racional, uma vez que nÃo houve diferenÃa entre os esquemas antibiÃticos empregados.Rheumatoid arthritis (RA) is an autoimmune condition characterized by an inflammation of the joints. The medications most commonly used in the treatment of RA are disease modifying antirheumatic drugs (DMARDs) such as methotrexate (MTX) and biological agents such as tumor necrosis factor alpha inhibitors (anti-TNF-α). These drugs are immunosuppressive and they are related to a higher incidence of infections. The aim of this study was to evaluate the occurrence of inflammation, pain, scarring, and the presence of infections after tooth extraction in patients with RA treated with anti-TNF-α and MTX that used pre or postoperative amoxicillin. The RA patients were divided randomly into two groups: Group A (antibiotic prophylaxis â a single dose of amoxicillin 2g orally, 1h prior to the procedure) and group B (postoperatively antibiotic - 500mg of amoxicillin 8/8h for 5 days). In addition, a third group was created for control purposes that consisted of patients without RA and with no prescription of antibiotics. After evaluation of hematologic and radiographic parameters were performed 30 extractions (13 patients with RA and 12 in control group) by a single operator. The distribution of medications was made randomly and double-blind. Periodic evaluation (1,3,7,14 and 30 days after the procedure) were taken in order to identify clinical and radiographic signs of infection, inflammation. The evaluation of wound healing was done through measurement with a caliper at intervals of 24 hours, 72 hours, 7 days, and 14 days. A visual analogue scale (VAS) was used for verification of painful symptoms which was delivered to the patients after the extractions. All patients had 3 periapical radiographs (before extraction, with 24 hours and after 30 days) that were digitized and analyzed by ImageJÂ software to verify radiographic healing period by modifying the alveolar radiolucent area. Most participants were women in control group (58.3%) and in groups A and B (83.3% and 100% respectively). Platelet levels of patients in groups A and B were higher than the control group (p = 0.008). In regard to inflammatory and infection signs, there was no significant difference between the three groups, as well as in pain levels and bone regeneration assessed radiographically, unlike tissue healing rates, where the groups A and B showed smaller areas of surgical wounds and the wounds contraction better than the control group (p = 0.005). Patients in groups A and B showed bone healing, inflammation and infection rate similar to the control group, however, the tissue healing parameters in groups A and B were higher when compared to the control group. In conclusion, it might be wise to suggest the use of amoxicillin prophylaxis considering rational antimicrobial use, since there was no difference between antibiotic regimens employed.
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Armond, Anna Catharina Vieira. "Acupuntura no controle de dor, edema, trismo e ansiedade associados ? exodontia de terceiros molares mandibulares: ensaio cl?nico randomizado controlado triplo cego." UFVJM, 2017. http://acervo.ufvjm.edu.br/jspui/handle/1/1475.
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O objetivo deste estudo foi avaliar a efic?cia da acupuntura no controle de dor, edema e trismo ap?s exodontia de terceiros molares e controle da ansiedade pr?-operat?ria comparada ? acupuntura placebo. Para isso, um ensaio cl?nico randomizado, controlado, triplo-cego, no formato boca dividida, foi realizado. Dezesseis pacientes com m?dia de idade de 22,5 (?3,45) anos foram submetidos ? remo??o dos dois terceiros molares inferiores em momentos diferentes e receberam quatro sess?es de acupuntura, uma anterior ? cirurgia e outras nos momentos 24, 48 e 72 horas ap?s. Nos momentos do baseline, 24, 48, 72 horas e 7 dias ap?s a cirurgia, foram feitas avalia??es de edema, atrav?s das medidas da face e trismo, pela abertura m?xima bucal. A dor foi avaliada pela escala visual anal?gica nos momentos 24, 48 e 72 horas e a ansiedade foi avaliada pelo question?rio STAI (State-Trate Anxiety Inventory) e pela escala visual anal?gica nos momentos baseline e antes e depois da acupuntura no dia da cirurgia. A an?lise estat?stica foi feita pelo teste T pareado e Wilcoxon. A acupuntura obteve melhor desempenho no controle de edema nos momentos 48 horas (p=0,026), 72 horas (p=0,046) e 7 dias (p=0,040) quando comparada ao placebo. N?o houve diferen?a estat?stica no controle de dor, trismo e ansiedade entre os grupos. Em conclus?o, o uso da acupuntura apresentou melhores resultados no controle de edema ap?s exodontia de terceiros molares quando comparada ? acupuntura placebo.
Disserta??o (Mestrado) ? Programa de P?s-Gradua??o em Odontologia, Universidade Federal dos Vales do Jequitinhonha e Mucuri, 2017.
The objective of this study was to evaluate the efficacy of acupuncture in the control of pain, edema and trismus after third molar extraction and control of preoperative anxiety compared to placebo acupuncture. Thus, a randomized, controlled, triple-blind, split-mouth clinical trial was performed Sixteen patients with a mean age of 22.5 (?3,45) underwent removal of the two lower third molars at different times and received four acupuncture sessions, one prior to surgery and others at moments 24, 48 and 72 hours after. Edema evaluations were made through the measurements of the face and trismus by maximum buccal opening at the baseline and 24, 48, 72 hours and 7 days after surgery. The pain was evaluated by the visual analogue scale at moments 24, 48 and 72 hours and the anxiety was evaluated by the STAI questionnaire and the visual analogue scale at baseline and before and after acupuncture on the day of surgery. Statistical analysis was performed using the paired T test and Wilcoxon. Acupuncture showed better performance in the control of edema at 48 hours (p=0.026), 72 hours (p=0.046) and 7 days (p=0.040) when compared to placebo. There was no statistical difference in the control of pain, trismus and anxiety between the groups. In conclusion, the use of acupuncture showed better results on edema control after third molar extraction when compared to pacebo.
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Pulijala, Yeshwanth. "Learning through surgeon's eyes : design, development, and evaluation of an immersive virtual reality training tool for oral and maxillofacial surgery." Thesis, University of Huddersfield, 2017. http://eprints.hud.ac.uk/id/eprint/34446/.
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Background: Reduced training hours, over-crowded operating rooms, and lack of focus on non-technical skills are severely affecting surgical training. In specialities such as Oral and Maxillofacial Surgery, there is an increasing need for innovation in training. On the other hand, despite the application of technological advancements including virtual reality (VR) and augmented reality (AR), twenty-eight to forty percent of novice trainees are not confident in performing major surgery. The current research aims to address these challenges by finding a suitable way to develop an evidence-based immersive virtual reality (iVR) experience. Further, the research investigates the impact of this solution on the learning and confidence of trainees. This research introduces VR Surgery, an iVR experience, to address the gaps in the knowledge. VR Surgery is the first multi-sensory, holistic surgical training experience demonstrating Le Fort I osteotomy, a type of maxillofacial surgery, using Oculus Rift and Leap Motion devices. This research demonstrates the design, development and evaluation of VR Surgery and provides a way for future studies on the use of immersive technologies for surgical education. Methods: A design science research approach was followed to identify the problem, build the solution in collaboration with expert surgeons and evaluate it. Using a combination of multimedia, VR Surgery enables trainee surgeons to experience a realistic operating room environment, and interact with the patient’s anatomy while watching the surgery in a close-up stereoscopic 3D view. Consultant oral and maxillofacial surgeons in the UK evaluated VR Surgery for Face and Content validity. Surgeons commented on the content, usability and applicability of VR Surgery to surgical training. Further, to investigate the impact of VR Surgery on the perceived self-confidence of trainees, a single-blinded, parallel, randomised controlled trial (RCT) was performed. Surgical trainees (95) from seven dental schools took part in one of the first experiments to test the role of iVR on self-confidence. Experimental group participants learnt about the Le Fort I procedure using VR Surgery on an Oculus Rift. The control group used similar content in a standard PowerPoint presentation. The primary outcome measures were the self-assessment scores of trainees’ confidence as measured on a Likert scale and objective assessment based on the knowledge. Outcomes: The expert surgeons agreed with the validity of VR Surgery. The participants of the RCT were randomly divided into the experimental (51) and control (44) groups. Trainees had a mean age of 27∙14, and they were 45∙3% female students and 50∙5% male students. A repeated measures multivariate ANOVA was applied to the data to assess the overall impact of receiving the VR surgery intervention over conventional means on the confidence of trainees. Experimental group participants showed higher perceived self-confidence levels compared to those in the control group (p=0∙034, =0∙05). Novices in the first year of their training showed the highest improvement in their confidence, compared to those in the second and third year. Interpretation: Surgical trainees improve their knowledge and self-confidence levels after using an iVR training experience. The study proves that virtual reality applications such as VR Surgery have a substantial potential to bridge the differences in the quality of global surgical training. This research provides a framework for future researchers who use mixed reality for healthcare.
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Jonsson, Alexander, and Martin Husell. "Design of an oral surgery simulator : Human-centered design study and implementation on a surgerysimulator." Thesis, KTH, Maskinkonstruktion (Inst.), 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-226331.
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The company Forsslund Systems has developed a simulator for oral surgery training. The simulator, named Kobra, uses detailed virtual models of surgical situations, spatial haptics and a co-located stereoscopic display to provide an environment in which students can practice surgical techniques. Four years after the introduction of the Kobra a need was recognized for a new hardware design that satisfies the customers expectations on visual appearance and hardware refinement and that aims to improve the experience for the end users. This report describes the design development process of the new enclosure, that had a focus on human-centered design, brand management and small-scale manufacturing. Inspired by findings from a comprehensive user study, conducted at a teaching hospital in Riga and relevant literature, as well as the results of prototyping and testing, the new design of the Kobra aims to improve the usability and market attractiveness of the product offering. This while being tailored to utilize the manufacturing technologies available to a small-scale in-house or out-sourced production team. A full-scale functioning prototype of the concept was built in-house, using the proposed means of manufacture, demonstrating a design that is close to ready for production.Simulatorn, kallad Kobra, använder detaljerade virtuella modeller av kirurgiska ingrepp, 3D-haptik och en samlokaliserad stereoskopisk skärm för att skapa en miljö där elever kan öva kirurgiska tekniker. Fyra år efter introduktionen av Kobran klargjordes ett behov av en ny hårdvarudesign som uppfyller kundernas förväntningar på utseende och hårdvarukvalité samt som syftar till att förbättra upplevelsen för slutanvändarna. Denna rapport beskriver designutvecklingsprocessen av den nya exteriören, som hade utgångspunkt från människocentrerad design, varumärkeshantering och småskalig tillverkning. Inspirerad av insikter från en omfattande användarstudie, genomförd på ett lärosäte i Riga och relevant litteratur, såväl som resultaten av prototyptillverkning och utvärdering, syftar den nya designen av Kobran till att förbättra användbarhet och produktens marknadsläge. Detta medans designen är skräddarsydd för att utnyttja de tillverkningsprocesser som är tillgängliga för ett småskaligt internt eller externt produktionslag. En fullskalig fungerande prototyp av konceptet byggdes, med hjälp av de föreslagna tillverkningsmetoderna, som påvisade en nära produktionsklar design.
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Scaggs, Huang Felicia. "Potential Pathogens Are Predominant in the Oral Microbiome of Pediatric Intensive Care Unit Patients." University of Cincinnati / OhioLINK, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1563272800210079.
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Orgill, Joshua J. "The impact of luminance on localizing the inferior alveolar canal on cone beam computed tomography." Thesis, University of Iowa, 2019. https://ir.uiowa.edu/etd/6824.
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Introduction: The use of CBCT to visualize the relationship between the inferior alveolar canal and the mandibular third molar roots continues to grow as it is becoming the standard of care. It becomes important to understand the impact that luminance, one of the factors that affects the viewing conditions of digital images, has on appropriately assessing the third molar-canal relationship. To date, no study has assessed the impact of luminance on visualizing anatomic structures on CBCT. The aim of this study is to determine if there is a difference in the ability to appropriately assess the root development and the third molar-canal relationship on a medical grade monitor with four different luminance settings on CBCT.
Materials and methods: 285 scans were randomized and evaluated by three calibrated and masked evaluators. The evaluations were completed on a Barco MDNC-3321 Nio Color 3MP monitor (Kortrijk, Belgium) monitor at four different luminance settings; 200 cd/m2, 300 cd/m2, 400 cd/m2, and 500 cd/m2. The gold standard was established by two board-certified oral and maxillofacial radiologists. All evaluations were performed in a controlled subdued environment lighting of less than 15 lux. There was a washout period of at least one week between each of the four evaluations by an observer.
Results: The accuracy of two of the three evaluators was substantial to almost perfect independent of luminance. None of these assessments showed any statistical significance (P = 0.05). The accuracy of one evaluator was moderate to almost perfect for all evaluations with one assessment of one canal showing statistical significance (P = 0.05).
Conclusion: There is no difference in the ability to appropriately assess the third molar canal relationship or the root development of third molars on a medical grade monitor at luminance settings between the range of 200 cd/m2 and 500 cd/m2 when viewed in a dimly lit room.
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Pilon, Danielle. "Oral anticoagulants and the risk of an osteoporotic fracture among the elderly." Thesis, McGill University, 2001. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=33823.
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Background. Oral anticoagulants are associated with a decrease in bone mass density. Our study evaluates the association between an osteoporotic fracture and oral anticoagulants.Methods. We conducted a case-control study on subjects aged 70 years and older enrolled in the Quebec health insurance plan between 1992 and 1994. Incident cases of an osteoporotic fracture (index event) were identified by ICD-9 codes and surgical procedure codes. Exposure defined as one or more prescriptions of oral anticoagulants dispensed before the index event. Ten controls for each case, matched by age and date of index event, were selected.
Results. Among 1,523 cases, 48 (3.2%) were exposed to oral an anticoagulant; among 15,205 controls, 461 (3.0%) were exposed (adjusted odds ratio: 1.1, 95% CI: 0.8--1.4). These negative results persisted after stratifying the exposure into the cumulative dose and duration of treatment.
Conclusions. Oral anticoagulants are not significantly associated with an osteoporotic fracture in the elderly.
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Viana, Thales Salles Angelim. "Quality of life of patients with oral cancer treated by primary surgery - preoperative and postoperative analysis." Universidade Federal do CearÃ, 2014. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=14210.
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nÃo hÃIntroduction: The increasing prevalence of chronic degenerative diseases, especially various types of malignant lesions, shows a major change in the morbidity and mortality of the world population profile. According to the World Health Organization (WHO), there were 14,1 million incident cases and 8,2 million cancer deaths in 2012. Oral cancer is a serious and growing problem in many parts of the world. Brazilian male population is considered the third highest risk for oral cancer in the world, after countries like France and India. The treatment of oral cancer is undoubtedly related to a decrease in quality of life (QOL), which can generate significant functional, aesthetic and emotional changes. The measurement of QOL allows monitoring, as well as understanding of the real impact of the disease and its treatment on patients lives. Objective: To measure the QOL of patients treated with primary surgery for oral cancer, through an analysis of preoperative and postoperative. Methods: A prospective cross-sectional study in which 54 patients treated with primary surgery for oral cancer from August 2012 to October 2013 were included. Patients were treated at the Hospital Haroldo JuaÃaba - Cancer Institute of Cearà (HHJ-ICC) in Fortaleza, CearÃ, Brazil. For analysis of QOL, the questionnaire of the University of Washington (UW-QOL) for head and neck cancer (CCP) at pre and post-operative was used. The clinicopathological profile and lifestyle were also collected. Categorical data were analyzed by means of confidence intervals and Fisher exact or Chi-square test. The variation in scores QOL the preoperative to the postoperative period was assessed using the Wilcoxon test (nonparametric data). Data were exported to the Statistical Packcage for Social Sciences and adopted a confidence of 95% (p<0,05) in all analyzes. Results: The prevalence was higher in males (72,2%; p=0,018) with a mean of 61,1Â13,9 years old, with the majority having completed elementary school (33,3%; p=0,001) or incomplete (33,3%; p=0,001) and natural in the state (63%; p<0,001). As for lifestyle, most of the selected patients were smokers (81,5%), alcoholic (63,0%) and worked out in the sun (77,8%). The lesions were more prevalent in language, followed by lip and oral floor and classified primarily as stage IV (40,8%) and I (34,7%). QOL analysis, comparing the first phase and immediate postoperative, showed a drop in appearance scores, activity, recreation, swallowing, chewing, talking, shoulder function, saliva, and especially the palate (p=0,001). As for the areas of pain, mood and anxiety had improved. On the importance of pain domains, mood and anxiety stood out, with statistical significance compared with the postoperative phase. In the postoperative period, the domains speech and shoulder function were also statistically significant compared to the previous time. In absolute terms had pain, anxiety and swallowing were quite cited preoperatively and chewing and swallowing postoperatively. Most patients rated their QOL related to health and general as good and very good in the postoperative period. Conclusion: The UW-QOL was an effective tool in the analysis of the sample. Although still the most widely used treatment, surgical resection in the treatment of oral malignant lesions contributed negatively to QOL, especially on the functional aspects of the stomatognathic system. Even with the worsening of individual domains, patients classified as positive their overall QOL and health-related postoperative. Clinical Relevance: Identification of the most affected areas and its importance throughout surgical treatment for subsequent performance in policies for prevention and care to these patients. The reflection and the search for new technologies in cancer treatment are necessary.
IntroduÃÃo: O aumento da prevalÃncia de doenÃas crÃnico-degenerativas, especialmente os vÃrios tipos de lesÃes malignas, mostra uma importante mudanÃa no perfil de morbidade e mortalidade da populaÃÃo mundial. De acordo com dados da OrganizaÃÃo Mundial de SaÃde (OMS), houve 14,1 milhÃes de casos incidentes e 8,2 milhÃes de mortes por cÃncer em 2012. O cÃncer de boca à um problema grave e crescente em vÃrias partes do mundo. A populaÃÃo masculina brasileira à considerada a terceira de maior risco para o cÃncer de boca no mundo, depois de paÃses como FranÃa e Ãndia. A terapÃutica do cÃncer oral Ã, sem dÃvida, relacionada a uma diminuiÃÃo na qualidade de vida (QV), podendo gerar significativas mudanÃas funcionais, estÃticas e emocionais. A mensuraÃÃo da QV permite o monitoramento, assim como a compreensÃo do real impacto da doenÃa e seu tratamento na vida dos pacientes. Objetivo: Mensurar a QV de pacientes tratados com cirurgia primÃria para cÃncer de boca, por meio de uma anÃlise prÃ-operatÃria e pÃs-operatÃria. MÃtodos: Estudo prospectivo transversal, no qual foram incluÃdos 54 pacientes tratados com cirurgia primÃria para cÃncer de boca no perÃodo de agosto de 2012 a outubro de 2013. Os pacientes foram atendidos no Hospital Haroldo JuaÃaba â Instituto do CÃncer do Cearà (HHJ-ICC) em Fortaleza, CearÃ, Brasil. Para anÃlise da QV, foi utilizado o questionÃrio da Universidade de Washington (UW-QOL) para cÃncer de cabeÃa e pescoÃo (CCP) no momento prà e pÃs-operatÃrio. O perfil clinicopatolÃgico e o estilo de vida tambÃm foram coletados. Os dados categÃricos foram analisados por meio de seus intervalos de confianÃa e teste Exato de Fisher ou Qui-quadrado. A variaÃÃo dos escores de QV do prÃ-operatÃrio ao pÃs-operatÃrio foi avaliada por meio do teste de Wilcoxon (dados nÃo-paramÃtricos). Os dados foram exportados para o Statistical Packcage for the Social Sciences e adotou-se uma confianÃa de 95% (p<0,05) para todas as anÃlises. Resultados: A prevalÃncia foi maior no sexo masculino (72,2%; p=0,018) com uma mÃdia de 61,1Â13,9 anos de idade, sendo a maioria com ensino fundamental completo (33,3%; p=0,001) ou incompleto (33,3%; p=0,001) e naturais do interior do estado (63%; p<0,001). Quanto ao estilo de vida, a maioria dos pacientes selecionados eram fumantes (81,5%), etilistas (63,0%) e trabalhavam expostos ao sol (77,8%). As lesÃes foram mais prevalentes em lÃngua, seguida por lÃbio e assoalho bucal e classificadas, principalmente, como estÃgio IV (40,8%) e I (34,7%). A anÃlise da QV, comparando a fase prÃvia e pÃs-operatÃria imediata, mostrou uma queda dos escores de aparÃncia, atividade, recreaÃÃo, deglutiÃÃo, mastigaÃÃo, fala, funÃÃo do ombro, saliva e, principalmente, o paladar (p=0,001). Jà os domÃnios da dor, humor e ansiedade tiveram uma melhora significativa. Quanto à importÃncia dos domÃnios dor, humor e ansiedade se destacaram, com significÃncia estatÃstica comparados com a fase pÃs-operatÃria. Jà no pÃs-operatÃrio, os domÃnios fala e funÃÃo do ombro tambÃm tiveram significÃncia estatÃstica comparativamente ao momento anterior. Em valores absolutos tivemos dor, ansiedade e deglutiÃÃo foram bastante citados no prÃ-operatÃrio e mastigaÃÃo e deglutiÃÃo no pÃs-operatÃrio. A maioria dos pacientes classificaram sua QV relacionada à saÃde e geral como boa e muito boa no pÃs-operatÃrio. ConclusÃo: O UW-QOL foi uma ferramenta eficaz na anÃlise da amostra estudada. Apesar de ainda ser o tratamento mais utilizado, a ressecÃÃo cirÃrgica no tratamento de lesÃes malignas orais contribuiu negativamente para a QV, principalmente nos aspectos funcionais do sistema estomatognÃtico. Mesmo com a piora dos domÃnios individuais, os pacientes classificaram como positiva sua QV geral e relacionada à saÃde no pÃs-operatÃrio. RelevÃncia clÃnica: IdentificaÃÃo dos domÃnios mais afetados e sua importÃncia ao longo do tratamento cirÃrgico, para posterior atuaÃÃo em polÃticas de prevenÃÃo e atenÃÃo a esses pacientes. A reflexÃo e a busca de novas tecnologias no tratamento oncolÃgico se faz necessÃrio.
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MURGIA, Denise. "NEW GUIDED BONE REGENERATION PROCEDURE USING LEUKOCYTE AND PLATELET RICH FIBRIN (L PRF) IN ORAL SURGERY." Doctoral thesis, Università degli Studi di Palermo, 2021. http://hdl.handle.net/10447/500658.
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Non-transfusional hemocomponents are autogenous products used in several surgical fields obtained by the centrifugation of a blood sample from a patient and able to promote hard and soft tissue regeneration, local haemostasis, and the acceleration of wound healing.
The aim of this PhD thesis was the validation of an innovative protocol for the Guided Bone Regeneration (GBR) technique using second-generation autologous platelet concentrates, Leukocytes and Platelet-rich Fibrin (L-PRF), in post-extraction sockets of patients in need of dental avulsions and successive implant prosthetic rehabilitation, evaluating its ability to prevent alveolar bone resorption and promote bone regeneration.
The secondary aim was the design and development of a multicomposite loaded with antimicrobic and antioxidant agents, to be applied wrapped in the L-PRF membrane, enhancing its regenerative properties.
This project cohering with the National Operational Program (PON) “Research and Innovation” (R&I) 2014-2020 funding by the Italian Ministry of Education, University and Research, aimed to promote the research and the innovation of the country, with a particular interest on the Health Specialization Area.
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Paleckis, Laura Guimarães Pagliuso. "Reparação inicial de enxertos ósseos autógenos em bloco ou em particulas : estudo microscópico em mandíbula de cães /." Araçatuba, 2004. http://hdl.handle.net/11449/101069.
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Orientador: Paulo Sérgio Perri de CarvalhoBanca: Alberto Consolaro
Banca: Luis Ronaldo Picosse
Banca: Edgard Franco Moraes Júnior
Resumo: A reabsorção óssea associada à perda dos dentes por vezes impossibilita a instalação imediata de implantes dentários. Nesta circunstância, pode ser necessária a reconstrução óssea prévia, realizada por meio de enxertos ósseos autógenos. A compreensão dos fenômenos iniciais da reparação dos enxertos é fundamental para favorecer sua consolidação clínica. Neste estudo, foram realizados enxertos ósseos autógenos em bloco ou em partículas na mandíbula de 6 cães, bilateralmente. Os leitos receptores foram preparados, os blocos foram rigidamente fixados e os enxertos em partículas foram adaptados e condensados. Três animais foram sacrificados após 7 dias e os outros 3, após 14 dias. Os espécimes foram submetidos a análise microscópica. Após 7 dias, os enxertos em bloco exibiram desvitalização, com canais vasculares vazios e interface enxerto-leito constituída por um tecido conjuntivo vascularizado e rico em fibras colágenas. As partículas, desvitalizadas, foram completamente envolvidas por tecido conjuntivo, com áreas de reabsorção osteoclástica. Aos 14 dias, os blocos já eram invadidos por canais de reabsorção, e os canais vasculares de Havers e Volkmann eram alargados e revascularizados junto ao leito. As partículas foram quase completamente reabsorvidas e o tecido conjuntivo circundante já exibia áreas de neoformação óssea. As perfurações do leito e a região adjacente ao parafuso de fixação foram sede de início de osteogênese. Os resultados mostraram que a reparação inicial dos enxertos em bloco caracteriza-se por lenta revascularização a partir do leito receptor, que requer alargamento dos canais vasculares préexistentes, enquanto as partículas são rapidamente reabsorvidas.
Abstract: Sometimes, bone resorption in association with loss of teeth makes it impossible to immediately perform dental implants. Under this circumstance, previous bone reconstruction would be necessary, through autogenous bone grafts. The understanding of the initial phenomena involved with bone grafting repair is fundamental for a clinical success. In this study, block or particulate autogenous bone grafts were placed bilaterally in mandibles of dogs. The host sites were prepared, the blocks rigidly fixated, and the particulate graft s were adapted and condensed. Three animals were sacrificed after 7 days, and the other 3, after 14 days. The samples were processed for microscopic analysis. After 7 days, the grafted blocks showed devitalization and empty vessel canals. The interface between the host site and the graft presented a vascularized connective tissue rich in collagen fibers. The grafted particles were devitalized and totally embedded in connective tissue. Areas of osteoclastic resorption were noticed in this group. At 14 days, resorption lacunae could be seen in the blocks. Harvers and Volkmann canals were elongated and revascularized at the host site. The particles had already been almost resorbed, and the surrounding connective tissue presented areas of new bone formation. The perforations of the host site and the region adjacent to the fixation screw represented areas where there was a beginning of osteogenesis. The results showed that the initial repair of block grafts was characterized by slow revascularization, starting from the host site, which required enlargement of pre-existing vascular canals. On the other hand, particulate bone grafts were rapidly resorbed and replaced by areas of forming bone.
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Bemfica, Jules Renan Dutra. "Cefalometria manual e digital em pacientes com anomalias dento-faciais esqueléticas." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2013. http://hdl.handle.net/10183/85148.
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As cirurgias ortognáticas são aceitas como alternativa de tratamento para anomalias dento-faciais de diferentes padrões morfológicos e magnitudes de discrepância maxilo-mandibular. Diferentes metodologias foram propostas na literatura para sua realização, a maior parte delas envolvendo múltiplas etapas de planejamento e métodos físicos de transferência deste para o campo operatório, envolvendo guias cirúrgicos físicos dento-suportados, bem como diferentes tipos de cirurgias de modelos ou tecnologias complexas. A análise cefalométrica é indicada para o diagnóstico, planejamento e o acompanhamento do resultado destas cirurgias, podendo ser obtida de forma manual ou por meio de traçado digital. O objetivo deste estudo foi comparar dados obtidos com cefalometria manual e digital, para determinar a existência de diferenças ente as grandezas cefalométricas analisadas. Foram realizados traçados cefalométricos em 38 telerradiografias laterais de pacientes diagnosticados com anomalia dento-facial pelo mesmo cirurgião, utilizando-se ambos os métodos. Os valores aferidos foram comparados utilizando-se o teste tpareado, o qual demonstrou diferença estatística para os ângulos IMPA e PHF.PO (p<0,05). Conclui-se que pode haver diferença nos valores quando utiliza-se um ou outro método, no entanto sugere-se que essas discrepâncias não são clinicamente válidas. Portanto, tanto o método manual como o digital, apresentam vantagens e desvantagens, mas parecem ser confiáveis para realização de diagnóstico e conseguinte planejamento de cirurgia ortognática.Combined orthognathic surgery are accepted as alternative treatment for dentofacial anomalies with different morphological patterns and magnitudes of maxillo-mandibular discrepancy. Different methods were proposed in the literature for its realization, most of them involving multiple stages of planning and physical methods of transferring this to the operative field, involving surgical guides dental-supported as well as different types of surgeries models or complex technologies. The cephalometric analysis is indicated for the diagnosis, treatment planning and evaluation of the surgical outcome, either by manual or digital tracing. The aim of this study was to compare data obtained from manual and digital cephalometric tracings, evaluatingpossible differences between the methods. Digital and manual cephalometry were performed in 38 lateral cephalometric radiographs of patients previously diagnosed with dentofacial anomalies, and the data was compared using the paired t test. Significant differences were found for the angles PHF.PO and IMPA angles (p <0,05). However the magnitude of the differences was low. The findings reinforce previous data suggesting that there may be differencein measurement values obtained by these methods, however these differences have no clinical impact. Both the manual and digital methods seem to bereliable for diagnosis and treatment planning of skeletal dentofacial anomalies.
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Fraser, Andrew Gordon. "The elimination of susceptibility bias in the study of adult female class II division 1 cases treated either with orthognathic surgery or orthodontics : a project report submitted as partial fulfilment for the degree of Master of Dental Surgery /." Title page, contents and summary only, 1997. http://web4.library.adelaide.edu.au/theses/09DM/09dmf841.pdf.
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Rattray, Megan E. "Improving feeding practices and intakes among patients who have undergone surgery using a knowledge translation approach." Thesis, Griffith University, 2019. http://hdl.handle.net/10072/389756.
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A convincing body of evidence exists supporting the reintroduction of liquids and solids within 24 hours after surgery. This practice is defined as early oral feeding and has been associated with faster recovery of gastrointestinal function, improved quality of life and reduced morbidity among various patient populations. In addition, the rapid reintroduction of nutrition after surgery is important for reducing the risk of malnutrition and its associated consequences. Hence, nutrition recommendations have been incorporated into evidence-based guidelines for postoperative care among gynaecologic, hepatic, pancreaticoduodenal, gastrectomy, colorectal, rectal and pelvic patients. Despite clear guidelines, it is well known that the adoption of research findings into clinical practice is often a slow process, with evidence taking up to two decades to be established in habitual practice. Indeed, international and national surveys have reported a gap between evidence-based recommendations and practice for initiating and progressing patients onto nutritionally adequate solid diets following surgery. Collectively, this evidence provides a strong rationale for interventions targeting improved nutrition care following surgery.
Integrated knowledge translation has emerged as an effective method for translating research findings into habitual practice across a range of healthcare settings. As such, this thesis describes how an integrated knowledge translation approach and the Knowledge to Action framework was used to guide the design a four-phased, multimethod program of research, aiming to improve nutrition practices and intakes among patients who have undergone surgery. Six studies were generated within this four-phased program of research. A programmatic approach was applied so that each phase (and study) informed the next.
Studies 1-2 were undertaken in Phase 1: ‘Identify the problem’. Study 1, a systematic review including 29 articles, was conducted to identify and quantify the prevalence of delayed postoperative feeding across different healthcare settings and patient groups. Study 2, an observational investigation of 100 postsurgical patients, was conducted to precisely identify the prevalence of delayed and inadequate feeding, the contributing factors, and the patient group in greatest need of intervention. Collectively, these studies demonstrated that delayed diet prescription and delivery in conjunction with patient-related factors contributed to suboptimal feeding practices and nutritional intakes. Further, patients who had undergone lower gastrointestinal surgery were identified as the highest risk group, with the greatest disparity between recommendations and current practice. Hence, the knowledge generated
in Phase 1 suggested an intervention targeting professional, organisational and patient factors was warranted among individuals who have undergone colorectal surgery.
Studies 3-5 were undertaken in Phase 2: ‘Adapting knowledge to local context and assess barriers to new knowledge use’. Study 3, a qualitative investigation involving 16 patients who had undergone colorectal surgery, was conducted to provide an in-depth understanding of the issues that individuals face immediately following surgery. Studies 4 and 5 focused on exploring staffs’ perceptions of nutrition among patients who have undergone colorectal surgery. Specifically, Study 4 was conducted to identify factors that multidisciplinary hospital staff (n = 18) perceived to influence timely and adequate feeding, while Study 5 was undertaken to explore the factors influencing doctors’ (n = 21) decision-making regarding postoperative nutrition prescription. Study findings generated from this phase indicated that providing simple, clear and encouraging dietary-related information to patients, introducing a flexible feeding protocol, supporting doctors’ knowledge around clinical nutrition and gaining buy-in from senior medical staff may be effective strategies to improve nutrition practices and dietary intakes among patients who undergo colorectal surgery.
Phase 3 involved ‘selecting, tailoring and implementing an intervention’ designed to improve nutrition practices and intakes among patients who undergo elective colorectal surgery. Consultation with knowledge users in the local setting and findings generated from Phases 1-2 (Studies 1-5) informed the selection and tailoring of the intervention. A multifaceted intervention including staff- and patient-related strategies was designed and implemented. Phase 4: ‘Monitor and evaluate outcomes’ involved evaluating the intervention through a pilot study (Study 6). This mixed methods investigation included pre- (n = 30) and post-intervention (n = 34) patients and was undertaken to evaluate a) the processes underpinning intervention implementation; and b) the outcomes of the intervention. Significant improvements in times to first diet prescription, delivery and intake; and patients’ nutritional intakes for the first 2 days after surgery were observed. However, times to first solid diet prescription, delivery and intake, and the overall proportion of patients who met their nutritional requirements for at least one day while in hospital, did not significantly differ from pre- to post-intervention. These findings are likely explained by the variable uptake of intervention strategies (0-100%). Overall, this body of research has significantly contributed to existing knowledge around nutrition practices and intakes among patients who undergo surgery and provides useful insights for clinicians and researchers seeking to implement evidence-based nutrition guidelines in their own setting.Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School Allied Health Sciences
Griffith Health
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Méndez-Manjón, Irene. "Three-dimensional evaluation of changes in condylar morphology and position in patients undergoing orthognathic surgery." Doctoral thesis, Universitat Internacional de Catalunya, 2017. http://hdl.handle.net/10803/456245.
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La presente tesis doctoral es un compendio de 4 publicaciones sobre los cambios posicionales y morfológicos que ocurren en la articulación temporomandibular tras la realización de cirugía ortognática.
Del estudio de campo realizado se concluye que se producen cambios estadísticamente significativos en la posición del cóndilo articular tras la cirugía de avance mandibular.
Adicionalmente se valida la utilización de la tomografía computerizada de haz cónico para el estudio morfológico y posicional de la articulación temporomandibular. Esta validación se compone de dos estudios: En el primero se valida la precisión y reproducidibilidad de la superposición tridimensional de los volúmenes obtenidos del CBCT para estudiar los cambios que se producen en cirugía ortognática y más concretamente en la articulación termporomandibular. El segundo estudio, valida la obtención de la reconstrucción tridimensional del volumen de interés ( cóndilo articular) mediante un método de segmentación semiautomática basado en Unidades Hounsfield.
Por último se define la realización de una técnica quirúrgica de exéresis intraoral de hiperplasias condilares que es posible gracias sa la aplicación de las técnicas de diagnóstico y planificación tridimensional.
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Mlynarek, Marcin Aleksander. "Proteomics and the identification of serum biomarkers in a mouse model of oral squamous cell carcinoma." Thesis, McGill University, 2006. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=101731.
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Objective. To establish a clinically relevant model for the identification of protein serum biomarkers for oral squamous cell carcinoma, and to identify specific candidate proteins.Methods. Samples of oral cancer and adjacent normal tissue were obtained and were transplanted orthotopically into tongues of immunocompromised mice. When the mice lost 20% of their weight, they were sacrificed by exsanguinations. The serum was analyzed by two separate protocols: DIGE/MALDI and MudPIT/LC/ESI. Preliminary validation was conducted on an established cancer marker.
Results. We identified over one hundred proteins as being differentially expressed between control and cancer-bearing mice (p<0.05); including EGFR, cytokeratin 10, gelsolin, titin, vitronectin, retinoblastoma protein family, bullous pemphigoid antigen, and clusterin.
Conclusion. We report a proteomic approach for the identification of serum biomarkers of oral cancer using an orthotopic mouse model. We identified several proteins that can be exploited as potential markers for diagnosis of oral squamous cell carcinoma.
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Van, Eeden Simon Peter. "The effect of a topical combined anti-inflammatory antibiotic preparation on the outcome of third molar surgery." Diss., Pretoria : [s.n.], 2000. http://upetd.up.ac.za/thesis/available/etd-01052007-123151/.
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Faria, Júnior Norberto Batista de [UNESP]. "Estudo in vitro de apicectomia e retropreparos realizados por diferentes métodos." Universidade Estadual Paulista (UNESP), 2008. http://hdl.handle.net/11449/90402.
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Este estudo objetivou: (1) comparar a topografia superficial e a interface entre a obturação e as paredes do canal de raízes seccionadas com laser, ultra-som ou broca; (2) avaliar o efeito do preparo retrógrado com retropontas ultra-sônicas ou laser na integridade da superfície apical; (3) e avaliar a espessura de dentina remanescente após retropreparos com laser ou ultra-som verificando sua correlação com o surgimento de trincas. Trinta dentes instrumentados e obturados foram usados para cada situação. No experimento 1, foram avaliados três métodos de apicectomias: broca Zekrya, ponta ultra-sônica CVD (9.5107-8) e laser de ErCr:YSGG (Waterlase). Para os experimentos 2 e 3, cavidades retrógradas foram preparadas com retropontas CVD (6.1107-6), retropontas EMS (DT-060/Berutti) ou laser de ErCr:YSGG. O tempo de preparo das apicectomias e das cavidades apicais foi registrado. Réplicas em resina epóxica das superfícies radiculares foram avaliadas por MEV. Todos os dados foram submetidos ao devido tratamento estatístico (Shapiro-Wilk, ANOVA, Tukey, Kruskal-Wallis, Student-Newman-Keuls) com α = 5%. A avaliação das réplicas após as apicectomias não revelou trincas e nem fraturas em nenhum dos grupos. A Zekrya apresentou o menor tempo para concluir as apicectomias (p<0,05) e produziu a superfície mais lisa e plana (p<0,05). A melhor adaptação entre obturação/dentina ocorreu no grupo do laser, mas sem diferença significativa para o ultra-som (p>0,05). A avaliação das réplicas das cavidades retrógradas mostrou que o laser de ErCr:YSGG removeu mais estrutura dental que as retropontas CVD e EMS (p<0,05). O Waterlase teve a maior média de tempo para os retropreparos (p<0,05). Fraturas no ângulo cavo-superficial ocorreram apenas no grupo da retroponta EMS. Os grupos CVD e EMS apresentaram melhores escores relacionados à qualidade do preparo do que o grupo com laser ErCr:YSGG (p<0,05).
This study aimed: (1) to compare the surface topography, and the interface between the obturation and the root canal walls of roots resected with laser, ultrasonic tip, or bur; (2) to investigate the effect of retrograde preparations by using ultrasonic tips or laser on the integrity of root-end surfaces; (3) and to compare the thickness of surrounding dentine after ultra-sonics or laser root-end cavity preparation and its relationship with cracking formation. Thirty instrumented and root filled teeth were select for each situation. For the experiment 1, three root-end resections methods were evaluated: Zekrya bur, CVD (9.5107-8) ultra-sonic tip, and ErCr:YSGG laser (Waterlase). For the experiments 2 and 3, root-end cavities were prepared by CVD (6.1107-6) ultra-sonic tip, EMS (DT060/Berutti) ultra-sonic tip or ErCr:YSGG laser.The time required to cut through the apical portion of the root and to prepare the rootend cavity was recorded. Epoxy resin replicas of the root surfaces were assessed by SEM. Statistical analyses were performed using Shapiro-Wilk, ANOVA, Tukey, Kruskal-Wallis, and Student-Newman-Keuls tets (α = 5%). Assessment of the replicas of apices after apicectomy did not reveal cracks or fractures in any specimen. The Zekrya bur showed the lowest mean time to cut through the root-ends (p<0.05) and produced the smoothest and most uniplanar resected root surfaces (p<0.05). The best adaptation between the obturation and the root canal walls of roots was observed in laser group, but it did not differ from ultra-sonics group (p>0.05). The evaluation of the root-end cavities replicas showed that the ErCr:YSGG laser removed more dental structure than the CVD and EMS tips (p<0,05). The Waterlase showed the highest mean time to prepare the root-end cavity (p<0.05).
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Costa, Delson João da. "Avaliação do tempo de tratamento ortodontico em pacientes submetidos a cirurgia ortognatica." [s.n.], 2007. http://repositorio.unicamp.br/jspui/handle/REPOSIP/287877.
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Orientador: Marcio de MoraesTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba
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Resumo: A associação do tratamento ortodôntico-cirúrgico possibilita bons resultados funcionais e estéticos dos pacientes com deformidades dentofaciais e requer períodos variáveis de ortodontia pré e pós-cirúrgica. A duração destes períodos de ortodontia é influenciada por uma série de características inerentes a cada caso clínico e o seu conhecimento possibilita expectativas reais e a satisfação do paciente. O objetivo deste estudo foi avaliar o tempo de tratamento ortodôntico em pacientes submetidos ao tratamento ortodôntico-cirúrgico e investigar fatores que podem influenciá-lo. Foi realizada avaliação retrospectiva de prontuários de 65 pacientes submetidos à cirurgia ortognática entre 1994 e 2004, operados nos Serviços de Cirurgia e Traumatologia Buco-Maxilo-Faciais da FOP/UNICAMP, São Paulo e Hospital XV, em Curitiba, Paraná. As variáveis. investigadas foram: limitação do tratamento ortodôntico isolado, indecisão do paciente quanto ao procedimento cirúrgico, gravidez, tracionamentos dentários, problemas pessoais e clínicos, faltas excessivas ao tratamento ortodôntico e doenças sistêmicas. A faixa etária compreendeu entre 16 a 45 anos de idade com média de 25,7 anos. Na distribuição quanto ao gênero houve a predominância do gênero feminino (67%) em relação ao gênero masculino (33%), sendo que todos os pacientes eram da raça branca. Os fatores que podem alterar o tempo de tratamento ortodôntico nas fases pré e pós-cirúrgica são discutidos, utilizando a técnica (filosofia) ortodôntica bioprogressiva de Ricketts. A média de tratamento pré-cirúrgico ficou em 21 meses, sendo que no pós-cirúrgico foi de 17 meses com o tempo total de 38meses. A duração do tempo de tratamento ortodôntico não foi influenciada pelas variáveis estudadas. Um estudo prospectivo, com amostra maior, poderia especificar quais variáveis resultam em alterações significativas na duração do tempo de tratamento ortodôntico pré e pós-cirurgia ortognática
Abstract: The purpose of this study was to evaluate the length of the orthodontic treatment on patients submitted to a combined orthodontic-surgical treatment. The study comprised data analysis from the information found on the charts of 65 (sixty-five) patients: 35 (thirty-five) treated at "FOP/UNICAMP", São Paulo, and 30 (thirty) treated at "Hospital XV", in Curitiba, Paraná, from January of 1994 to December of 2004. Patients ranged from 16 to 45 years of age, with an average of 25.7 years. Most of the patients were white females (67%), while 36% were white males. The orthodontic treatment was based on the Ricketts Bio-progressive Orthodontic Philosophy, and factors that could affect the length of orthodontic treatment before and after surgery were Gliscussed. The average length of the orthodontic treatment before surgery was 21 months, while the after surgery average time was 17 months, with a total length of 38 months. Among the factors that can affect the total length of the surgical-orthodontic treatment are: limitations and compensations of the orthodontic treatment, patient reluctance on having the surgical procedure done, pregnancy, impacted teeth, personal and clinical issues, missed orthodontic appointments and systemic diseases. The length of the orthodontic treatment on patients submitted to orthognathic surgery can vary depending on factors related to the difficulty of the technique facing dental and skeletal discrepancies, and the variables related to personal conditions of the patients
Doutorado
Cirurgia e Traumatologia Buco-Maxilo-Faciais
Doutor em Clínica Odontológica
46
Moreira, Alcides. "Analgesia preemptiva versus analgesia preventiva com lumiracoxibe em cirurgias de terceiros molares retidos." [s.n.], 2010. http://repositorio.unicamp.br/jspui/handle/REPOSIP/290774.
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Orientador: Eduardo Dias de AndradeTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba
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Resumo: A analgesia preemptiva consiste na instituição de um regime analgésico previamente ao estímulo nociceptivo, com o objetivo de prevenir a hiperalgesia e a subsequente amplificação da dor. O objetivo deste trabalho foi avaliar a analgesia preemptiva com o lumiracoxibe, inibidor seletivo da cicloxigenase-2 (COX-2), em exodontias bilaterais de terceiros molares mandibulares retidos, comparando-a à analgesia preventiva. Foram selecionados 16 voluntários com bom estado de saúde geral, com indicação para a remoção dos dois terceiros molares mandibulares retidos, em posições simétricas e assintomáticos. O estudo foi delineado de forma duplo-cego e cruzado. Em uma das cirurgias os voluntários foram tratados com lumiracoxibe 400 mg, via oral, em dose única, administrada uma hora antes da cirurgia, seguido da administração de placebo, logo após o término do procedimento. Na cirurgia contralateral, de modo inverso, o tratamento consistiu do uso do placebo antes da intervenção, seguido da administração de lumiracoxibe 400 mg após o término do ato cirúrgico. A eficácia dos regimes analgésicos foi avaliada pelos seguintes parâmetros: tempo decorrido para a tomada do primeiro comprimido de analgésico a partir do final da intervenção; quantidade de comprimidos de analgésico tomada nas primeiras 24 h do pósoperatório; escala visual analógica nos tempos de 4, 8, 12 e 24 h e qualidade do tratamento. Não houve diferenças estatisticamente significantes entre os tratamentos preemptivo e preventivo no que se refere ao tempo requerido para a tomada da primeira dose de analgésico: 241,5 (±322,5) e 137,2 (± 246,48) minutos (p=0,3633); quantidade de comprimidos analgésicos tomados no período pósoperatório: 2,6 (±2,56) e 4,2 (± 5,13) comprimidos (p=0,5471), qualidade do tratamento (p=0,6794) e escala visual analógica (p=0,3916). Concluiu-se que o tratamento com lumiracoxibe, prévio ao estímulo nociceptivo (analgesia preemptiva) ou posterior a ele (analgesia preventiva), promove efeito analgésico efetivo e similar em cirurgias de terceiros molares mandibulares retidos.
Abstract: Preemptive analgesia is defined as an analgesic regimen established before the occurrence of noxious stimulus in order to prevent hyperalgesia and subsequent amplification of pain. The aim of this study was to evaluate the preemptive analgesia with lumiracoxib, a selective cicloxigenase-2 (COX-2) inhibitor, in impacted third molars surgery, compared to the protocol of preventive analgesia. Sixteen subjects who required elective surgical removal of symmetric and asymptomatic impacted mandibular third molars, in an outpatient setting were selected for the study, characterized as double-blind and crossover. In one of the surgeries, the volunteers where treated with lumiracoxib 400 mg orally in a single dose given one hour before surgery, followed by administration of placebo, immediately after the end of the procedure. Conversely, in contralateral surgery, treatment consisted of using placebo before intervention, followed by administration of lumiracoxib 400 mg after surgery. The effectiveness of analgesia was evaluated by the following parameters: time elapsed from the end of the intervention, until the first analgesic intake in the postoperative period; number of analgesic tablets consumed in the first 24 hours after surgery; visual analog scale (VAS) at of 4, 8, 12 and 24 h after the surgery and treatment quality. There were o statistically significant differences between preemptive and preventive treatments in relation to the time required for the first analgesic intake: 241.5 (± 322.5) and 137.2 (± 246.48) minutes (p = 0.3633), number of analgesic tablets taken in the postoperative period: 2.6 (± 2.56) and 4.2 (± 5.13) tablets (p = 0.5471), quality of treatment (p = 0.6794) and visual analog scale (p = 0.3916). It was concluded that treatment with lumiracoxib, prior to noxious stimulation (preemptive analgesia) or after it (preventive analgesia), promotes similar analgesic effect in lower impacted third molars surgery.
Doutorado
Farmacologia, Anestesiologia e Terapeutica
Doutor em Odontologia
47
Hafner-Cirne, Maylu Botta 1982. "Efeito de informações pré-operatórias, técnico e sensorial, na percepção e nos comportamentos de dor em pacientes submetidos à exodontia de terceiro molar = Effects of pre-operative technical and sensorial information on perception and pain behavior in patients undergoing third molar extraction." [s.n.], 2015. http://repositorio.unicamp.br/jspui/handle/REPOSIP/288047.
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Orientadores: Maria da Luz Rosario de Sousa, Antonio Bento Alves de MoraesTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba
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Resumo: O objetivo do trabalho foi avaliar a eficácia do oferecimento prévio de informações técnicas e sensoriais na percepção e respostas de dor dos pacientes submetidos à exodontia. Participaram deste estudo 145 pacientes, com idade entre 14 e 24 anos, que necessitavam de exodontia de, pelo menos, um terceiro molar em sessão odontológica. Os pacientes foram alocados aleatoriamente em três diferentes grupos (Controle - GC, Experimental Técnico - GET e Experimental Sensorial - GES). O planejamento experimental foi subdividido em 6 momentos: Pré-cirúrgico, Pós-cirúrgico I, II, III, IV e Remoção de Sutura. No Pré-cirúrgico foi aplicada uma entrevista inicial com questões abertas e fechadas sobre hábitos de saúde, experiência cirúrgica e uso de medicamentos, bem como aplicação dos questionários e escalas de dor e apresentação de um vídeo informativo (somente para os grupos experimentais). Nos momentos Pós-cirúrgico II III e IV ocorreu a aplicação do Questionário de Dor McGill e da Escala VAS de Funcionalidades, sendo que nesses momentos o paciente respondeu aos instrumentos em casa. No momento de remoção de sutura foram recolhidos os instrumentos de avaliação e foi aplicada uma avaliação do vídeo informativo. A partir das avaliações e entrevistas puderam ser identificadas alterações que podem ser atribuídas à apresentação de informação prévia e, consequentemente, variação na percepção de dor do paciente em relação ao GC. Tanto os pacientes que receberam informações técnicas, como os que receberam informações sensoriais relataram menores escores de dor ao longo do pós-operatório. No entanto, mesmo com relatos de baixa percepção de dor, todos os pacientes ingeriram quantidades similares de analgésicos no pós-operatório. É importante destacar que a maior parte dos pacientes experimentais relatou a experiência de receber informações detalhadas como positivas
Abstract: The objective was to evaluate the effectiveness of the previous offering technical and sensory information to perception and pain responses of patients undergoing third molar extraction. The study included 145 patients, aged 14 and 24, who needed extraction of at least one third molar. Patients were randomly divided into three groups (Control - CG, Technical - TG and Sensory - SG). The experimental design was divided into six phases: Pre-surgical, post-surgical I, II, III, IV and suture removal. In the Pre-Surgical was applied an initial interview with open and closed questions about health habits, surgical experience and use of medicines as well as the questionnaires, pain scales and presenting an informative video (for the experimental groups). In the post-surgical moments II III and IV was the application of the McGill Pain Questionnaire and VAS scale features, and the patient responded to the instruments at home. At the time of suture removal the assessment tools were collected and applied an assessment of the informative video. From the reviews and interviews have been identified changes that could be attributed to the presentation of prior information and hence variation in the perception of the patient's pain compared to CG. Both patients who received technical information, such as receiving sensory information reported lower pain scores throughout the postoperative period. However, even with low pain perception reported, all patients ate similar amounts of analgesics postoperative. Importantly, most of the experimental subjects reported the experience of receiving detailed information as positive
Doutorado
Saude Coletiva
Doutora em Odontologia
48
Faria, Júnior Norberto Batista de. "Estudo in vitro de apicectomia e retropreparos realizados por diferentes métodos /." Araraquara : [s.n.], 2008. http://hdl.handle.net/11449/90402.
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Orientador: Fabio Luiz Camargo Villela BerbertBanca: Clóvis Monteiro Bramante
Banca: Mário Tanomaru Filho
Resumo: Este estudo objetivou: (1) comparar a topografia superficial e a interface entre a obturação e as paredes do canal de raízes seccionadas com laser, ultra-som ou broca; (2) avaliar o efeito do preparo retrógrado com retropontas ultra-sônicas ou laser na integridade da superfície apical; (3) e avaliar a espessura de dentina remanescente após retropreparos com laser ou ultra-som verificando sua correlação com o surgimento de trincas. Trinta dentes instrumentados e obturados foram usados para cada situação. No experimento 1, foram avaliados três métodos de apicectomias: broca Zekrya, ponta ultra-sônica CVD (9.5107-8) e laser de ErCr:YSGG (Waterlase). Para os experimentos 2 e 3, cavidades retrógradas foram preparadas com retropontas CVD (6.1107-6), retropontas EMS (DT-060/Berutti) ou laser de ErCr:YSGG. O tempo de preparo das apicectomias e das cavidades apicais foi registrado. Réplicas em resina epóxica das superfícies radiculares foram avaliadas por MEV. Todos os dados foram submetidos ao devido tratamento estatístico (Shapiro-Wilk, ANOVA, Tukey, Kruskal-Wallis, Student-Newman-Keuls) com α = 5%. A avaliação das réplicas após as apicectomias não revelou trincas e nem fraturas em nenhum dos grupos. A Zekrya apresentou o menor tempo para concluir as apicectomias (p<0,05) e produziu a superfície mais lisa e plana (p<0,05). A melhor adaptação entre obturação/dentina ocorreu no grupo do laser, mas sem diferença significativa para o ultra-som (p>0,05). A avaliação das réplicas das cavidades retrógradas mostrou que o laser de ErCr:YSGG removeu mais estrutura dental que as retropontas CVD e EMS (p<0,05). O Waterlase teve a maior média de tempo para os retropreparos (p<0,05). Fraturas no ângulo cavo-superficial ocorreram apenas no grupo da retroponta EMS. Os grupos CVD e EMS apresentaram melhores escores relacionados à qualidade do preparo do que o grupo com laser ErCr:YSGG (p<0,05).
Abstract: This study aimed: (1) to compare the surface topography, and the interface between the obturation and the root canal walls of roots resected with laser, ultrasonic tip, or bur; (2) to investigate the effect of retrograde preparations by using ultrasonic tips or laser on the integrity of root-end surfaces; (3) and to compare the thickness of surrounding dentine after ultra-sonics or laser root-end cavity preparation and its relationship with cracking formation. Thirty instrumented and root filled teeth were select for each situation. For the experiment 1, three root-end resections methods were evaluated: Zekrya bur, CVD (9.5107-8) ultra-sonic tip, and ErCr:YSGG laser (Waterlase). For the experiments 2 and 3, root-end cavities were prepared by CVD (6.1107-6) ultra-sonic tip, EMS (DT060/Berutti) ultra-sonic tip or ErCr:YSGG laser.The time required to cut through the apical portion of the root and to prepare the rootend cavity was recorded. Epoxy resin replicas of the root surfaces were assessed by SEM. Statistical analyses were performed using Shapiro-Wilk, ANOVA, Tukey, Kruskal-Wallis, and Student-Newman-Keuls tets (α = 5%). Assessment of the replicas of apices after apicectomy did not reveal cracks or fractures in any specimen. The Zekrya bur showed the lowest mean time to cut through the root-ends (p<0.05) and produced the smoothest and most uniplanar resected root surfaces (p<0.05). The best adaptation between the obturation and the root canal walls of roots was observed in laser group, but it did not differ from ultra-sonics group (p>0.05). The evaluation of the root-end cavities replicas showed that the ErCr:YSGG laser removed more dental structure than the CVD and EMS tips (p<0,05). The Waterlase showed the highest mean time to prepare the root-end cavity (p<0.05).
Mestre
49
Gimenez, Carla Maria Melleiro. "Avaliação cefalométrica do perfil mole de paciente face longa submetido à cirurgia ortognática : estudo retrospectivo /." Araçatuba, 2004. http://hdl.handle.net/11449/95789.
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Resumo: A face longa é uma deformidade dentofacial com envolvimento esquelético, de prognóstico desfavorável em termos de metas de correção e estabilidade, que interfere intensamente na qualidade funcional do sistema estomatognático e na percepção estética da imagem individual. Esse desequilíbrio vertical é mais comumente observado nos pacientes portadores de má oclusão de Classe II, sendo a estratégia de tratamento mais bem sucedida a combinação dos procedimentos ortodônticos aliados à cirurgia ortognática. O presente trabalho teve a proposição de comparar o perfil tegumentar pós-operatório de pacientes padrão face longa submetidos ao tratamento ortodôntico-cirúrgico, com os parâmetros descritos na análise cefalométrica de Legan e Burstone (1980). Para isso, 32 telerradiografias pós-cirúrgicas com um mínimo de 6 meses de acompanhamento foram submetidas a traçado manual (repetido 4 vezes) e digitalização (também repetida 4 vezes) no programa DFPlus para análise cefalométrica. Os resultados permitiram verificar que 9 das 11 mediadas avaliadas encontravam-se estatisticamente diferentes da norma avaliada; contudo, ao verificar-se o desvio padrão permitido na norma, os achados deste trabalho situam-se dentro da mesma. As condições experimentais deste estudo permitiram concluir que a análise cefalométrica estudada não foi exata para avaliação da qualidade do resultado pós-operatório na população estudada, devendo, portanto, a avaliação dos resultados após a cirurgia ortognática ser principalmente clínica, e que a estética facial não está totalmente relacionada com as medidas preestabelecidas na análise cefalométrica.Abstract: The high mandibular plane angle is a dentofacial deformity with skeletal changes, unfavourable prognosis relationed with objectives of correction and stability, which interfere on stomatognatic system's functional quality and on esthetic perception of individual image. This vertical desarrangement is more usual in Class II patients, considering the best form of treatment the combination of orthodontic approach with orthognathic surgery. The aim of this research was to compare the postoperative tegumentar profile of vertical facial growth pattern patients treated by orthognathic surgery approach, in relation with the norms discribes in literature on the Legan & Burstone cephalometric analysis (1980). Thirty two postoperatives lateral cephalograms, with a accompaniment minimum of six months de was submiting to manual tracing, digitalization on DFPlus program and cephalometric analysis. The results indicate that 9 of the 11 avaliable references was statisticaly diferent of the norm, although if examine the admited pattern deviation on the norm, the basis was placed into the same. The experimental conditions of this study permit to conclude that the studied cephalometric analysis was not exact to evaluate the quality of postoperative results on the verified sample. Therefore, the postoperative results' assessment must be mainly clinical; and the facial esthetic is not whole relationed with preestabilished measurements on cephalometrics analysis.
Orientador: Francisco Antonio Bertoz
Coorientador: Marisa Aparecida Cabrini Gabrielli
Mestre
50
Sahlin, Maria. "Sväljningssvårigheter hos patienter opererade för munhålecancer : en litteraturstudie." Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-168213.
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Syftet med denna litteraturstudie var att belysa sväljningssvårigheter hos patienter som genomgått kirurgisk behandling på grund av munhålecancer genom att undersöka vad som bidrar till sväljningssvårigheter, hur patienterna upplever sväljningen samt hur vårdpersonalen kan hjälpa dessa patienter. Studien baserades på 12 vetenskapliga artiklar som söktes fram i databaserna PubMed och Cinahl. Resultatet indelades utifrån vilket metodologiskt tillvägagångssätt som använts i studierna, videofluoroskopi respektive frågeformulär. Förekomst och resektion av tumör i orofarynx, särskilt tungbasen, gav större sväljningsdysfunktion jämfört med orala tumörer i flera av videofluoroskopistudierna. När frågeformulär användes för att undersöka patienternas självupplevda sväljning sågs att strålbehandling var en viktig negativ faktor för sväljningen. I flera av studierna sågs att större resektionstorlek/tumörstorlek eller ett avancerat sjukdomsstadie hade negativ inverkan på sväljningen. Aspekter av munfunktionen rankades som mest betydande av 12 viktiga funktioner i en studie, med sväljningen på fjärde plats. I en studie som undersökt livskvalitet relaterad till sväljningssvårigheter var ”tid för ätande”, ”problem att tugga”, ”problem med mat som fastnar i munnen” de faktorer som gav lägst livskvalitet. Vid sökning efter studier som kunde svara på vilka åtgärder omvårdnadspersonal kan tillämpa för att hjälpa munhålecanceropererade patienter med sväljningssvårigheter framkom ingen relevant studie.The aim of this literature review was to illuminate swallowing difficulties in oral and oropharyngeal cancer patients treated with surgery by studying which factors contribute to swallowing difficulties, how these patients experience their swallowing and how nursing staff can assist them. The study was based on 12 research articles. The literature search was performed in the PubMed and Cinahl databases. The result was subdevided on the basis of the methods used in the studies, videofluoroscopy and questionnaires. The presence and resection of tumours of the oropharynx, in particular of the base of the tongue, resulted in more severe swallowing dysfunction compared to tumours of the oral cavity in several of the videofluoroscopic studies. Self-assessment questionnaires showed that radiation therapy had a mayor negative effect on swallowing. In several studies large tumours/resections and an advanced stage had a negative impact on swallowing. In one study aspects of mouth function was ranked to be the most important of 12 important issues, swallowing coming in fourth place. One study that evaluated quality of life related to swallowing after surgery, found that the main factors effecting the quality of life were “eating duration”, “problems chewing” and “food sticking in your mouth”. In the search for studies answering the question of what actions nursing staff can apply in caring of oral and oropharyngeal cancer patients with swallowing difficulties after surgery no relevant study was found.