https://tede.unioeste.br/handle/tede/525 Tue, 12 May 2026 09:03:31 GMT 2026-05-12T09:03:31Z https://tede.unioeste.br/handle/tede/8358 Title: Avaliação do canal mésio-vestibular de molares decíduos prototipados após a instrumentação manual e rotatória Autor: FERRARI, Helena Irene Primeiro orientador: Hoshi, Adriano Tomio Abstract: The preservation of primary teeth until physiological exfoliation is essential for proper oral development in children. Endodontic treatment is indicated in cases of pulpal involvement, and root canal instrumentation remains one of the main challenges, particularly due to the complex root canal anatomy. Rotary systems specifically designed for primary teeth have been introduced as an alternative to improve clinical efficiency. The aim of this study was to evaluate volumetric changes and root canal wall wear in prototyped primary teeth following instrumentation with manual files and two rotary systems, including one specifically designed for primary teeth, using micro-computed tomography. Thirty-six prototyped maxillary second primary molars were used and divided into three groups (n = 12) according to the instrumentation technique: manual K-files (MANUAL), ProDesign Logic 2 (LOGIC), and Sequence Baby-File (SBF). The specimens were scanned using micro-computed tomography before and after instrumentation to measure canal volume and dentin wall thickness in the mesiobuccal root canal. Data were analyzed using BioEstat 5.3 software. Shapiro–Wilk, ANOVA, and Tukey tests were applied for volumetric analysis, while Kruskal–Wallis and Dunn tests were used for dentin wall thickness, with a significance level set at 5%. Canal volume increase was higher in the MANUAL group (21.0%), followed by SBF (17.9%) and LOGIC (12.0%), with a significant difference between MANUAL and LOGIC (p < 0.05). Regarding dentin wall thickness, no statistically significant differences were observed among the systems; however, greater dentin wear was observed in the apical third across all groups. All three systems demonstrated similar performance in preserving root canal wall thickness and promoting canal volume increase. Publisher: Universidade Estadual do Oeste do Paraná Tipo do documento: Dissertação Mon, 01 Dec 2025 00:00:00 GMT https://tede.unioeste.br/handle/tede/8358 2025-12-01T00:00:00Z https://tede.unioeste.br/handle/tede/8078 Title: Associação entre perda de inserção periodontal, infecções relacionadas à assistência à saúde e mortalidade em pacientes hospitalizados em unidade de terapia intensiva: estudo transversal Autor: Pase, Marilia Primeiro orientador: Nassar, Patricia Oehlmeyer Abstract: Healthcare-associated infections (HAIs) have a significant impact on patients admitted to intensive care units (ICUs), contributing to prolonged hospitalization, elevated healthcare expenditures, and increased mortality rates. Periodontitis has been associated with certain systemic diseases, since the inflammatory response is not limited to the periodontal tissues and can disseminate through the vascular system. In hospitalized patients, there is an higher risk of periodontal pathogen proliferation, potentially representing a critical step in the systemic dissemination of bacteria. The objective of this study is to evaluate the association between periodontal inflammation, HAIs and mortality in intubated patients, hospitalized in the ICU. Methodology: This is an observational cross-sectional study with a quantitative data analysis. Data collection was conducted in the ICU of a reference hospital at the Paraná’s western region. The included patients were under mechanical ventilation via an orotracheal tube, for a period ranging from 24 to 72 hours. The periodontal clinical examination and a gingival crevicular fluid collection were performed. Patient data and laboratorial test results were collected from the electronic medical record system, and the HAIs diagnoses were provided by the hospital. The data were presented through descriptive parameters. Continuous and discrete quantitative variables were analyzed using the Student’s t-test for unpaired samples. The variables that did not show a normal distribution (assessed by the Shapiro-Wilk test and Q-Q plot) were analyzed using the non-parametric Mann-Whitney test. Nominal qualitative variables related to sample characteristics, clinical conditions, and periodontal diagnosis were evaluated using the chi-square test. The logistic regression method was used to determine if periodontal variables and HAIs could predict the risk of mortality. The study sample comprised 50 patients. Results: The average age of patients who were discharged was of 48.3 ± 15.6 years old, while those who progressed to death had an average age of 61.1 ± 17.0 years old, with this difference being statistically significant. The loss of periodontal attachment in the 3-4 mm range was significantly greater in the group of patients who progressed to death (6 ± 7) compared to the group that was discharged (3 ± 7), with p = 0.021. The attachment level ≥ 3 mm was identified as a significant predictor for mortality. Conclusion: Mortality is associated with advanced age and with periodontal attachment loss of 3–4 mm, compared to younger patients with less periodontal involvement. Furthermore, the presence of HAIs and attachment loss ≥3 mm increase the risk of death. Publisher: Universidade Estadual do Oeste do Paraná Tipo do documento: Dissertação Thu, 31 Jul 2025 00:00:00 GMT https://tede.unioeste.br/handle/tede/8078 2025-07-31T00:00:00Z https://tede.unioeste.br/handle/tede/8013 Title: Avaliação clínica do impacto da associação entre Fibrina rica em plaquetas avançada A- (PRF) e laserterapia de baixa potência (TLBP) na área doadora palatina após remoção de enxerto de tecido conjuntivo subepitelial: estudo clínico randomizado e cego Autor: Pereira, Juliana Reuter Primeiro orientador: Nassar, Carlos Augusto Abstract: The subepithelial connective tissue graft (SCTG) harvested from the hard palate, although effective, causes significant postoperative discomfort and impacts quality of life. Advanced platelet-rich fibrin (A- (PRF)) and low-level laser therapy (LLLT) have been proposed as adjuncts to optimize tissue repair and reduce morbidity. Objective: This study aimed to evaluate healing, pain, and quality of life after SCTG harvesting, comparing the use of A- (PRF) alone or combined with LLLT. Materials and Methods: Thirty patients with gingival recession underwent root coverage surgery with SCTG. The graft was harvested from the palatal region, where one A - (PRF) membrane was applied. Patients were allocated into two groups: A- (PRF) + LLLT group (A - (PRF) combined with a laser protocol) and A- (PRF) group (A- (PRF) alone). Follow-up was conducted over 90 days. Healing was assessed through standardized photographs using the Modified Manchester Scar Scale (MSS) and wound area measurement. Postoperative pain was evaluated using the Visual Analog Scale (VAS), and quality of life using the OHIP-14 questionnaire. Statistical analysis: Data were analyzed using paired t-test, Mann–Whitney, Kruskal–Wallis, Friedman, Durbin–Conover, and Fisher’s exact test (p < 0.05). Results: Results showed that the A- (PRF) + LLLT group experienced greater pain on postoperative day 5 (VAS 3.20 vs. 1.13; p = 0.0061), but consistently better quality of life scores (OHIP-14) at all-time points (p < 0.05). Although both groups achieved complete healing, the A- (PRF) group presented better aesthetic outcomes (p < 0.05 for total score, contour, and distortion at certain time points). No significant differences were found in wound area or tissue thickness between groups. Conclusion: It is concluded that, under the adopted protocol, both therapies were safe and effective for palatal donor site healing, promoting progressive wound reduction, preservation of tissue thickness, and absence of complications. The adjunctive use of LLLT did not result in clinically significant additional benefits compared to A- (PRF) alone, except for a perceived improvement in patient-reported quality of life. Publisher: Universidade Estadual do Oeste do Paraná Tipo do documento: Dissertação Wed, 30 Jul 2025 00:00:00 GMT https://tede.unioeste.br/handle/tede/8013 2025-07-30T00:00:00Z https://tede.unioeste.br/handle/tede/8012 Title: 4 Avaliação dos efeitos da obesidade hipotalâmica associada a movimentação dentária induzida sobre a estrutura do periodonto de ratos Autor: Zibetti, Isabela Primeiro orientador: Amorim, João Paulo de Arruda Abstract: Obesity is a chronic multifactorial metabolic disease associated with several comorbidities. Among the various pathologies related to obesity, disturbances in bone metabolism and remodeling play a crucial role in orthodontic movement. This study aimed to evaluate whether hypothalamic obesity associated with induced tooth movement influences the histological structure of periodontal tissues in rats. Forty male Wistar rats, five days old, were obtained from the Central Animal Facility of the State University of Western Paraná. Twenty neonatal rats were administered subcutaneous injections of monosodium glutamate (4g/kg/day) in the cervical region during the first five days of life to induce obesity (MSG group), whereas twenty animals received hyperosmotic saline solution injections (1.25g/kg/day) (non-obese control group - CTL). After this period, the animals were divided into four experimental groups (n=10/group): G1: non-obese control group (CTL), rats that were not subjected to any experimental procedure; G2: CTL rats subjected to induced tooth movement (CTL + ITM); G3: obese rats without induced tooth movement (MSG); G4: obese rats subjected to induced tooth movement (MSG + ITM). At 90 days of age, the ITM device was installed in the CTL+ITM and MSG+ITM groups, and the total ITM period was seven days. This device consisted of a closed-coil nickel- titanium spring (Morelli®; Sorocaba, São Paulo, Brazil) exerting a force of 50 cN. At 97 days, all animals were weighed and euthanized, followed by decapitation. The right hemimaxillae were removed, fixed in 10% buffered formalin for 24 hours, washed in running water for 48 hours, and stored in 70% alcohol. After euthanasia, tooth movement was assessed by measuring the distance between the mesial surface of the first upper molar and the distal surface of the third upper molar on the right (moved) and left (non- moved) sides. For histological analyses, serial longitudinal sections were performed on the mesio-buccal and disto-buccal roots of the right first upper molar, from mesial to distal. The histopathological events investigated included external root resorption, hyalinized areas, acute inflammatory infiltrate, chronic inflammatory infiltrate, presence of multinucleated giant cells, vascular alterations, and periodontal ligament organization. Obese animals from the MSG groups showed increased Lee index and retroperitoneal and 7 perigonadal fat deposits compared to CTL animals. The obese animals in the MSG+ITM group showed a reduction in the rate of induced tooth movement when compared to the non-obese animals in the CTL+ITM group. None of the groups analyzed presented acute or chronic inflammatory processes. The animals in the MSG+ITM group showed an increase in areas of external root resorption, presence of multinucleated giant cells and disorganization of the periodontal ligament when compared to the other groups. The animals with CTL+ITM and MSG+ITM tooth movement presented the highest occurrences of hyalinization, while the obese animals (MSG and MSG+ITM) presented the highest frequencies of vascular alterations. We conclude that induced tooth movement associated with hypothalamic obesity causes a reduction in the orthodontic movement rate and greater occurrences of periodontal changes and external root resorption. Publisher: Universidade Estadual do Oeste do Paraná Tipo do documento: Dissertação Fri, 04 Apr 2025 00:00:00 GMT https://tede.unioeste.br/handle/tede/8012 2025-04-04T00:00:00Z