The precision of orthognathic surgery with customized titanium plates: a systematic review

The objective of this work was to do a systematic review to access the precision of orthognathic surgery with customized titanium plates in relation to the outcome of virtual planning. This is a systematic review with a protocol registered in the PROSPERO database, which followed the PRISMA guideline and Cochrane recommendations. Six databases and two gray literature repositories were used as sources of research articles. The research protocol was registered in PROSPERO (CRD42019133769). Descriptive clinical studies that performed orthognathic surgery using custom titanium plates were included. The risk of bias of the selected studies was assessed by “The Joanna Briggs Institute Critical Appraisal tools for use in Systematic Reviews Checklist for Case Series”. Of the 11,916 studies initially identified, 7 met the eligibility criteria and were included in this review. The studies were case series published between 2015 and 2019. Most of the studies (57%) had a low risk of bias, while only one had a high risk of bias. The total sample included 74 patients with 63 bimaxillary surgeries and 11 unimaxillary surgeries. It can be concluded thar all studies showed acceptable precision within previously established clinical parameters. Although the eligible articles assessed the precision of the orthognathic surgery with respect to virtual planning, the wide variability of evaluation methodologies made it impossible to calculate a combined precision measure. Nevertheless, all studies have suggested that the use of custom titanium plates in orthognathic surgery had high precision compared to the outcome of virtual planning.CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível SuperiorDissertação (Mestrado)O objetivo deste trabalho foi realizar uma revisão sistemática para avaliar a precisão da cirurgia ortognática com placas de titânio customizadas em relação ao planejamento virtual. Trata-se de uma revisão sistemática com protocolo registrado na base de dado PROSPERO, que seguiu o guideline PRISMA e recomendaçãoes Cochrane. Seis bases de dados (Embase, LILACS, PubMed, SciELO, Scopus, Web of Science) foram utilizadas como fonte primária de pesquisa. E duas bases (OpenThesis e OpenGrey) para capturar parte da literatura cinzenta. Foi realizado registro do protocolo de pesquisa junto ao PROSPERO (CRD42019133769). Foram incluídos estudos clínicos descritivos que realizaram cirurgia ortognática com o uso de placas de titânio customizadas, sem restrição de ano, idioma e status de publicação. O risco de viés dos estudos selecionados foi avaliado pela ferramenta “The Joanna Briggs Institute Critical Appraisal tools for use in JBI Systematic Reviews Checklist for Case Series”. Dos 11.916 estudos identificados inicialmente, somente sete preencheram os critérios de elegibilidade e foram incluídos nessa revisão. Os estudos são séries de casos publicados entre 2015 e 2019. A maioria dos estudos (57%) apresentou risco de viés baixo, enquanto apenas um estudo apresentou alto risco de viés. A amostra total incluiu 74 pacientes, com 63 cirurgias bimaxilares, e 11 cirurgias unimaxilares. Conclui-se que todos os estudos mostraram precisão aceitável dentro de parâmetros clínicos previamente estabelecidos. Embora todos os artigos elegíveis para esta revisão sistemática tenham comparado a precisão da cirurgia ortognática em relação ao planejamento virtual, a grande variabilidade das metodologias de avaliação impossibilitou o cálculo de uma medida de precisão combinada. Apesar disso, todos estudos sugeriram que a utilização de placas de titânio customizadas em cirurgia ortognática obteve alta precisão em relação ao planejamento virtual

Chemical and physical characterisation of three NHL 2 binders and the relationship with the mortar properties

In conservation works, the physical properties of mortars, such as compressive strength and porosity, are by far the most important for compatibility with, and protection and durability of historic fabric. The classification of Natural Hydraulic Lime (NHL) binders by the EN 459-1, gives little information about these properties for mortars, due to the unrepresentative nature of the standard samples used to categorise these binders, especially after 28 days of aging. As a consequence, although important for quality assurance and consistency of binder production, the standard test tends not to reflect the performance of mortars as made and used on-site, since these use different aggregates and water/binder ratios.In this work, three types of NHL 2 were analysed. These binders were characterised by means of X-ray diffraction and X-ray fluorescence. In addition to chemical tests, the surface area and bulk density data were also obtained. Mortar samples were manufactured using a sand aggregate which is appropriate for a conservation mortar with 1:2 ratio (binder:aggregate by volume). Sufficient water was added to produce a spread by flow table of 16510 [mm]. The chemical and physical properties of the binders were related to the physical characteristics of the mortars.The chemical and physical properties of different binders with the same NHL classification were found to vary greatly as did the properties of mortars at ages of 7, 14, 28, 90 and 180 days made with those binders. The need to develop a model to predict the performance of aged mortars based on the chemical and physical properties of the binders was identified.<br/

Chemical and physical characterisation of some NHL binders and the correlation with the mechanical properties of conservation mortars

The chemical and physical properties of Natural Hydraulic Limes (NHL) from a given manufacturer can change over time. Some quarries are deactivated or the extracted raw material properties vary depending on their geographical location. These variations in property make it harder for practitioners to predict how changing new products can be best used to match the requirements of a mortar for heritage conservation in terms of mechanical performance and durability. NHL in the UK market have been show to meet the requirements of BS EN 459-1. Although important for a consistent production quality this requirement employs tests based on standard samples which are unrepresentative in their nature. As a consequence, these seldom reflect the performance of mortars produced and used ‘on-site’. Mortars formed from the same class of NHL often exhibit distinct variations in property. In this work, a selection of NHL binders were characterised using X-ray diffraction, X-ray fluorescence and thermo-gravimetric analysis. In addition physical properties including bulk density, surface area and particle size were obtained. Initial chemical and physical properties were correlated to the final mechanical properties of the mortars produced with a readily available sand in a 1:2 mix ratio (binder:aggregate by volume). Distinct mechanical properties at the ages of 7, 14, 28 and 90 days were measured for the same class of NHL. These initial studies will be used to develop a model to predict the final mortar performance from an understanding of the chemical and physical properties of lime binder

Tratamento de sequela de trauma de terço médio da face: Cirurgia ortognática e aumento malar com enxerto de gordura pediculado

Maxillofacial injuries during childhood can create severe deformities as they interfere with the displacement of skull and face bones during normal growth. Occlusal abnormalities and skeletal discrepancies can occur due to several factors, with trauma being one of them. Deficiencies of the middle third of the face can be mitigated through different types of treatments, and the rotation of the buccal fat pad represents a technique for this problem, being simple and fast, with a low risk of complications. This paper reports the case of a Le Fort I type jaw fracture treated incorrectly during childhood. The patient evolved with insufficient maxillary development, an important deficiency of the facial middle third, and underwent orthognathic surgery along with malar repositioning of the buccal fat pad to restore occlusal and facial harmony. The treatment occurred correctly, without complications, and with the restoration of masticatory and respiratory function, improvement of facial aesthetics, and consequently, the quality of life of the patient. Facial trauma during childhood can negatively influence craniofacial growth, especially if treated incorrectly. This can lead to important deficiencies in adulthood, requiring orthognathic surgery to correct facial and occlusal disharmony. The use of buccal fat pad as a pediculated graft to gain projection of the facial middle third is an important technique with expressive results, which should be considered to improve facial aesthetics.Derly J. G. RodriguesLesões maxilo-faciais durante a infância podem criar deformidades graves por interferirem no deslocamento de ossos do crânio e face durante o crescimento normal. Anormalidades oclusais e discrepâncias esqueléticas podem ocorrer devido a diversos fatores, sendo o trauma um deles. Deficiências de terço médio da face podem ser atenuadas através de diversos tipos de tratamentos, e a rotação da bola de Bichat representa uma técnica simples e rápida, com baixo risco de complicações. Este trabalho relata o caso de uma fratura de maxila tipo Le Fort I tratada incorretamente durante a infância. A paciente evoluiu com desenvolvimento insuficiente de maxila, deficiência importante de terço médio facial, e foi submetida a uma cirurgia ortognática juntamente com reposicionamento malar da bola de Bichat para restauração da harmonia oclusal e facial. O tratamento ocorreu de forma correta, sem complicações, e com restabelecimento da função mastigatória, respiratória, melhora da estética facial, e consequentemente da qualidade de vida da paciente. O trauma facial durante a infância pode influenciar negativamente no crescimento craniofacial, especialmente se for tratado de forma incorreta. Isso pode acarretar deficiências importantes na idade adulta, exigindo cirurgia ortognática para correção das desarmonias faciais e oclusais. O uso da bola de Bichat como enxerto pediculado para ganho de projeção do terço médio facial é uma técnica importante com resultados expressivos, que deve ser considerada para melhora da estética facial

O papel do metacaulino na proteção do betão contra a ação dos cloretos

Mestrado em Engenharia CivilO metacaulino é uma pozolana cada vez mais utilizada como substituição do cimento Portland no betão com o objetivo de melhorar a durabilidade das estruturas, exercendo um papel na proteção contra a ação dos cloretos. Neste trabalho avalia-se a substituição de 10% da massa de cimento Portland num betão de traço comercial com resistência à compressão fck=30MPa. Com base em estudos já efetuados, sabe-se que para a percentagem de substituição considerada, a adição mineral de metacaulino promove um aumento da resistência mecânica do betão. Assim, além da mistura de referência, sem metacaulino, foram preparadas mais duas misturas com o objetivo de perceber a influência do metacaulino para betões da mesma faixa de resistência mecânica. Para avaliar as propriedades mecânicas dos diferentes tipos de betão considerados, foram realizados ensaios de compressão axial. A estrutura porosa das diferentes misturas foi avaliada através do ensaio de porosidade aberta. Realizou-se a aspersão de nitrato de prata nos provetes atacados por cloretos para se obter uma indicação do avanço da frente de cloretos pela matriz cimentícia. Por último, levaram-se a cabo ensaios de difração de raios-x e microscopia eletrónica de varrimento para verificar as potencialidades do metacaulino na fixação de cloretos na forma de Sal de Friedel e perceber as diferenças na estrutura resultante das diferentes misturas. Conclui-se que a substituição de cimento por metacaulino no betão tem um efeito positivo na diminuição da difusão de iões cloretos, quer pelo efeito de refinamento da estrutura porosa, quer pela capacidade de promover o aumento da formação de cloroaluminato de cálcio (sal de Friedel). O metacaulino mostra-se assim um agente eficaz na proteção do betão contra os efeitos prejudiciais dos cloretos.Com os resultados obtidos foi também possível concluir que é possível uma redução do consumo de cimento por substituição com metacaulino, resultando em betões pozolânicos com iguais ou melhores desempenhos que betões formulados apenas com cimento Portland.Metakaolin is a pozzolan increasingly employed in the replacement of Portland cement in concrete with the aim of improve the structures’ durability, having a role in the protection against the action of chlorides. This study evaluates the replacement of 10% of Portland cement mass with metakaolin, in a commercial concrete formulation with fck=30Mpa. Based on previous studies It’s known that this percentage of mineral addition of metakaolin increases the mechanical strength of concrete. Thus, besides the reference mixture without metakaolin, two more mixes were prepared. To evaluate the mechanical properties of the different types of concrete, axial compression tests were performed. The porous structure of the mixtureswas evaluated by open porosity tests. Specimens attacked by chlorides were sprayed with nitrated silver to obtain an indication of the chlorides advance in the cement matrix. Finally, x-ray diffraction and scanning electron microscopy test were made to check the potential of metakaolin in the combination with chlorides in the form of Friedel’s salt and to see the differences in the resulting structure from the different mixtures. It is conclude that the replacement of cement by metakaolin in concrete has a positive effect in reduction of chloride ions diffusion, by refining the pore structure and also by the ability to promote increased formation of Calcium chloroaluminate (Friedel’s salt). Metakaolin is an effective agent in protecting concrete against the damaging effects of chlorides. The obtained results leads to the conclusion that it is possible to reduce the consumption of cement in concrete by replacement with metakaolin, resulting in pozzolanic concretes with equal or better performance than regular Portland cement concretes

Health system reorientation for health promotion through social p rescribing

(...) A Prescrição Social concretiza e efetiva a ligação entre o SNS e todos estes agentes promotores da saúde na sociedade, conseguindo assim atuar nos determinantes sociais da saúde, que fora da esfera de atuação do Ministério da Saúde contribuem para 80% da saúde dos portugueses. Na prática, é um modelo que permite aos profissionais de saúde detetar em consulta situações de vulnerabilidade social ou necessidades ao nível do estilo de vida e referenciar o utente para um profissional de ligação ( social prescribing link worker ), que coordena uma rede local integrada de recursos comunitários de promoção de saúde e codesenha com o utente uma prescrição não-clínica, capaz de atuar positivamente no seu contexto de vida com benefícios para a sua saúde e bem- -estar. (...)info:eu-repo/semantics/publishedVersio

Frequency- and time-domain simulations of semiconductor optical amplifiers using equivalent circuit modeling

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)We propose an equivalent circuit modeling for a chip-on-carrier and for two encapsulated semiconductor optical amplifiers (SOAs). The models include main parasitic leaks and were used in reflection and transmission simulations, showing good agreement with experimental data. The model for each SOA is validated, comparing the simulated results with experimental data from SOAs operating as high-speed electro-optical switches, reaching rise times below 200 ps. (C) 2015 Society of Photo-Optical Instrumentation Engineers (SPIE)We propose an equivalent circuit modeling for a chip-on-carrier and for two encapsulated semiconductor optical amplifiers (SOAs). The models include main parasitic leaks and were used in reflection and transmission simulations, showing good agreement with5411CAPES - COORDENAÇÃO DE APERFEIÇOAMENTO DE PESSOAL DE NÍVEL SUPERIORCNPQ - CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICOFAPESP - FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULOCoordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)CNPq [574017/2008-9]FAPESP [2007/56024-4, 2005/51689-2]sem informação574017/2008-92007/56024-4 ; 2005/51689-2The authors thank Professor Adriano Toazza (UPF, RS/Brazil) for the software used to automate the EO transmission measurements. This work was supported in part by the Brazilian agencies CAPES and CNPq (scholarship), CNPq (under INCT-Fotonicom project, 57

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Chemical and physical characterisation of some NHL binders and the correlation with the mechanical properties of conservation mortars

The chemical and physical properties of Natural Hydraulic Limes (NHL) from a given manufacturer can change over time. Some quarries are deactivated or the extracted raw material properties vary depending on their geographical location. These variations in property make it harder for practitioners to predict how changing new products can be best used to match the requirements of a mortar for heritage conservation in terms of mechanical performance and durability. NHL in the UK market have been show to meet the requirements of BS EN 459-1. Although important for a consistent production quality this requirement employs tests based on standard samples which are unrepresentative in their nature. As a consequence, these seldom reflect the performance of mortars produced and used ‘on-site’. Mortars formed from the same class of NHL often exhibit distinct variations in property. In this work, a selection of NHL binders were characterised using X-ray diffraction, X-ray fluorescence and thermo-gravimetric analysis. In addition physical properties including bulk density, surface area and particle size were obtained. Initial chemical and physical properties were correlated to the final mechanical properties of the mortars produced with a readily available sand in a 1:2 mix ratio (binder:aggregate by volume). Distinct mechanical properties at the ages of 7, 14, 28 and 90 days were measured for the same class of NHL. These initial studies will be used to develop a model to predict the final mortar performance from an understanding of the chemical and physical properties of lime binder