Detecção de lesões cariosas em superficies oclusais : avaliação de diferentes tecnologias

Orientador: Antonio Carlos PereiraTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de PiracicabaResumo: O presente trabalho, composto por 3 estudos, teve como objetivo geral avaliar ¿in vitro¿ a eficácia e a reprodutibilidade de diferentes métodos diagnósticos para lesões cariosas em superfícies oclusais. A amostra dos estudos foi composta por 96 molares permanentes. O objetivo do 1º estudo foi comparar o desempenho dos sistemas de radiografia digital CDR (Schick Technologies, EUA) e Sidexis (Sirona, Bensheim, Alemanha) com o método radiográfico convencional, utilizando os resultados do exame histológico como método de validação. Dois examinadores realizaram todos os exames. Concluiu-se, a partir do cálculo da área abaixo da curva ROC para os métodos avaliados, que não houve diferenças estatisticamente significantes entre o desempenho do filme radiográfico convencional em relação aos dois sistemas digitais CCD para a detecção de lesões cariosas em superfície oclusais, porém, houve diferenças entre os dois últimos métodos avaliados. O objetivo do 2º estudo foi comparar o desempenho de 5 métodos de diagnóstico, ou seja, (1) o exame clínico-visual, (2) o radiográfico convencional, (3) o aparelho QLF (Inspektor Research System BV, Amsterdam, Holanda), (4) o aparelho ECM (LODE, Groningen, Holanda) e, (5) o aparelho DIAGNOdent (Kavo, Biberach, Alemanha) para a detecção de lesões cariosas em supefícies oclusais, comparado ao exame histológico. Os resultados demonstraram que o aparelho DIAGNOdent apresentou valores superiores de sensibilidade, especificifidade, acurácia e área abaixo da curva ROC (Az) em relação aos outros métodos avaliados. Conclui-se, portanto, que este método pode ser um importante adjunto aos exames convencionais nos casos em que há dúvidas quanto a higidez de uma fissura que não apresenta uma imagem radiolúcida ao exame radiográfico. O objetivo do 3º estudo foi comparar o desempenho de quatro métodos de iagnóstico em detectar e estimar a profundidade das lesões cariosas em superfícies oclusais em função dos resultados obtidos a partir de três métodos de validação, ou seja, o exame estereomicroscópio, a microrradiografia transversa e a microscopia confocal de varredura a laser e analisar a correlação entre eles. Concluiu-se, pelos resultados obtidos, que o desempenho dos métodos de diagnóstico não foi influenciado pelos resultados dos métodos de validação sendo que todos eles podem ser considerados fidedignos para se avaliar o desempenho dos métodos de diagnóstico avaliadosAbstract: The present thesis, composed by 3 studies, had as general objective to evaluate " in vitro" the efficacy and the reproducibility of different diagnostic methods for carious lesions on occlusal surfaces. The sample of the studies was composed by 96 extracted permanent molars. The objective of the 1st study was to compare the performance of the digital radiographic systems CDR (Schick Technologies, USA) and Sidexis (Sirona, Bensheim, Germany) with the conventional radiographic method for the detection of carious lesions in occlusal surfaces, using the histologic examination as validation method. Two examiners accomplished all the exams. It was concluded, starting from the calculation of the area below curved ROC for the evaluated methods, that there were not statistically significant differences between the performance of the conventional film and the two CCD digital systems for the detection of carious lesions in occlusal surfaces. However, it was found differences between the two last evaluated methods. The objective of the 2nd study was to compare " in vitro " the performance of 5 diagnostic methods, that is, (1) the clinical-visual exam, (2) the conventional radiographic examination, (3) the QLF device (Inspektor Research System BV, Amsterdam, Holland), (4) the ECM device (LODE, Groningen, Holland), and (5) the DIAGNOdent device (Kavo, Biberach, Germany) for the detection of carious lesions in occlusal surfaces. The results demonstrated that the DIAGNOdent device presented higher values of sensibility, specificity, accuracy and area below curved ROC (Az) in relation to the other methods. Therefore, it was concluded that this method can be an important adjunct to visual-radiographic examination when there is doubt in relation to the state of fissures. The objective of the 3rd study was to compare the performance of four diagnostic methods to detect and estimated the depth of the carious lesions in function of the results obtained from stereomicroscopy, transversal microradiograph and confocal laser scanning microscopy exams and to analyze the correlation among them. It was concluded, based on the obtained results that the performance of the diagnostic methods was not influenced by the results of thevalidation methods and all they can be considered trustworthy to evaluate the performance of the diagnosis methodsDoutoradoCariologiaDoutor em Odontologi

Evaluation Of Three Radiographic Methods For Detecting Occlusal Caries Lesions

Aim: To compare, in vitro, the performance of three radiographic methods for the detection of occlusal caries in permanent teeth. Methods: A total of 96 extracted molars with no apparent occlusal cavitation were selected, they were photographed and radiographed under standardized conditions using conventional E-plus films and two digital systems, CDR and Sidexis. Two examiners analyzed all films and images, recording the presence and lesion depth. One quarter of the teeth were re-examined for intra- and interexaminer agreements. The teeth were subsequently bisected and examined under a stereomicroscope. The intra and interexaminer agreements and the diagnostic performance (sensitivity, specificity, accuracy and the area under receiver operating characteristic, ROC curve) of each method were evaluated. Results: Out of 96 occlusal surfaces, 41 were sound, 31 had lesions in enamel, and 24 had dentin lesions. Weighted Kappa values for intraexaminer agreement varied widely, depending on both the observer and method. The interexaminer agreement was higher for the digital images than for the conventional films. The area under the ROC curve for enamel and dentin caries (at D1 diagnostic threshold) was 0.55 for films, 0.60 for Schick and 0.54 for Sirona, which were not significantly different from each other. Conclusions: Digital images presented better results of interexaminer agreement; however, no additional effect in the diagnostic performance could be observed in comparison to conventional films.8267-7

High Injection Effects on Solar Cell Performances

Experiments are performed on solar cells under concentrated sunlight in order to explore fundamental physical processes with high injection conditions. Saturation effects are observed on the cell open circuit voltage and on the extracted values of the recombination current. A large decrease of the initial decay of the transient voltage have been measured. High injection effects are shown to be correlated with the increase of recombination current in the space charge region together with an increase of the emitterbase coupling

Factors associated with the use of herbal medicines for oral problems by patients attending the clinics of the School of Dentistry, Federal University of Juiz de Fora, Brazil

AIM: To evaluate differences in sociodemographic characteristics (gender, age, educational level and income) between users and nonusers of phytotherapy for dental purposes; the degree of population's knowledge of herbal medicines for dental needs; and whether patients inform the health professional about their use of phytotherapy. METHODS: A questionnaire was applied to 100 patients in waiting rooms of the School of Dentistry of the Federal University of Juiz de Fora, in 2008, to inquire about sociodemographic variables and other factors associated with the use of phytotherapy. Statistical analyses were carried out using the chi square statistical test to calculate association between the variables, with 0.05 as level of significance. RESULTS: It was observed that 64.8% of participants were women with a mean age of 43.9±15.1 years. Phytotheraphy use for treatment of oral problems was reported by 37% of patients interviewed in this study. Significant differences were found between users and non-users of herbal medicines for oral problems, associated with the patient's age (p<0.05) and previous experience with use of phytotherapy to treat general health problems (p<0.001). CONCLUSIONS: The results emphasize the need for more scientific evidence of the efficacy of herbal medicinal products already incorporated in the popular knowledge to treat oral problems in order to make it an accessible and alternative method for prevention and therapy in dentistry.

A nacionalidade originária e a questão da dupla nacionalidade: jus soli e jus sanguinis em perspectiva histórica

Este artigo pretende estudar a nacionalidade originária nos trinta anos da Constituição brasileira de 1988 e a questão da dupla nacionalidade, tendo em vista a discussão do jus soli e do jus sanguinis em perspectiva histórica e examinar os artigos sobre nacionalidade nas constituições brasileiras. Em seguida, será apresentada a proposta de dupla nacionalidade elaborada pela Comissão Provisória de Estudos Constitucionais, em 1987, ignorada na redação do artigo 12 do texto original da Constituição de 1988 e posteriormente corrigida pela Emenda Constitucional de Revisão n°. 3, de 07 de junho de 1994. Nesta, o reconhecimento da dupla nacionalidade legitimou a aspiração de brasileiros de ascendência européia e flexibilizou o superado conceito de soberania absoluta, adequando o país às injunções de abertura de fronteiras e de integração de nações, permitindo a milhares de brasileiros o livre exercício da sua dupla nacionalidade

People should also look after the people: relational values of wildlife and collectively titled land in Ilkisongo Maasai group ranches in Southern Kenya

Categorically distinct instrumental values and non-instrumental “cultural” values of “nature” are central to ecosystemservices assessments and many wildlife conservation interventions alike. However, this approach to understanding the value of nature is at odds with social scientific understandings that see value as produced through social-ecological relations and processes. With a case study of Ilkisongo Maasai land users living in group ranches surrounding Amboseli National Park in southern Kenya, we apply a relational values approach to highlight the processes of valuation that shape how different people within Maasai society come to have different shared values of wildlife and collectively titled land. First, we detail how wildlife conservation efforts in Amboseli have affected social relations through uneven conservation decision-making processes and unequal distribution of benefits from conservation. Second, we detail how conservation practices have directly influenced changing relationships between people and wildlife. Neglect of elders’ common stances on how relations “ought” to be maintained (both human-human and human-nonhuman relations), and many Maasai residents’ views of the “ownership” of wildlife by a minority have both fueled resentment. We show that an ironic, unintended outcome is that conservation projects, which are intended to increase the “value” of wildlife for local people as a way to foster “coexistence” of people and wildlife on collectively titled lands, are instead contributing to an increased desire by some Maasai for wildlife to be spatially separated from people and livestock. Simultaneously, current conservation projects do not build upon practices that in Maasai views, enabled historical sharing of land with wildlife. Inequality and lack of participation have been highlighted as key limitations of many community-based conservation and human-wildlife conflict mitigation initiatives. We instead focus on how wildlife conservation interventions have contributed to changing human-human and human-nonhuman relations and have in turn impacted long-term Maasai perceptions of wildlife. We argue that an expanded consideration of relational values that emphasizes the inseparability of culture and nature, but also includes a central consideration of power dynamics, might overcome some limitations of previous valuation approaches.info:eu-repo/semantics/publishedVersio

Avaliação de diferentes metodos empregados para o diagnostico da carie dentaria

Orientador : Antonio Carlos PereiraDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de PiracicabaResumo: O maior contato das populações com os compostos fluoretados é apontado, segundo vários pesquisadores, como o principal responsável pela queda da prevalência da cárie dentária, verificada mundialmente, durante as últimas décadas. As cavitações cariosas, quando ocorrem, estão surgindo num estágio bem mais avançado de desenvolvimento da doença, que em épocas de alta prevalência e, portanto, a morfologia das lesões cariosas, está se alterando. Tal fato tem dificultado o diagnóstico da presença e profundidade das lesões cariosas, causando uma baixa concordância entre diferentes examinadores, quando examinando uma mesma amostra, para o diagnóstico e tipo de tratamento indicado para essa. Desse modo, observa-se que os dentistas podem concordar entre si, quanto ao diagnóstico da presença de uma lesão cariosa bem estabelecida, mas podem divergir entre si ao examinar uma superfície que apresenta uma lesão em estágios iniciais, através dos métodos tradicionais de diagnóstico, ou seja, o exame clínico e radiográfico. Outros métodos vêm sendo desenvolvidos para se tentar melhorar a capacidade do clínico em diagnosticar as lesões cariosas, entre eles, o exame videoscópico, FOTI e laser fluorescente, ainda que, pouco explorados pela literatura. Dentro desse contexto, devido à dificuldade encontrada pelos dentistas em diagnosticar e tratar corretamente as lesões cariosas, o presente trabalho teve como objetivos: 1) verificar a concordância no diagnóstico e tratamento da cárie em superfícies oclusais, através dos exames clínico e radiográfico, realizado por dentistas que trabalham em consultório particular, examinando uma mesma amostra e, calcular os prováveis custos envolvidos nessas variações; 2) avaliar "in vitro" o desempenho e reprodutibilidade dos métodos visual, videoscópico, FOTI e um aparelho de laser fluorescente (DIAGNOnodent®-Kavo) para o diagnóstico de cárie oclusal, utilizando o exame histológico como método de validação; 3) avaliar "in vivo" o desempenho dos métodos clínico, radiográfico e FOTI para o diagnóstico de lesões cariosas em superfícies proximais, em relação ao exame visual direto das superfícies, através da separação temporária dos dentes. Dentro das condições experimentais destes trabalhos, verificou-se que: 1) houve uma ampla variação no diagnóstico e indicação de tratamento para cáries em superfícies oclusais sugerido pelos dentistas, bem como, no custo dos tratamentos; 2) o exame visual, videoscópico e FOTI apresentaram baixos valores de sensibilidade, porém altos valores de especificidade para o diagnóstico de lesões cariosas localizadas em superfícies oclusais, enquanto o laser DIAGNOdent®apresentou elevados valores de sensibilidade às custas de um grande número de diagnósticos falso-positivos para o diagnóstico de cáries localizadas em nível de dentina; 3) O exame radiográfico apresentou o melhor desempenho para o diagnóstico de lesões nãocavitadas e cavitadas em relação ao exame clínico e FOTI para superfícies proximaisAbstract; The globally verified decline in dental caries prevalence is particularly related to the increased use of fluorides toothpaste, and carious lesion was observed to progress much slower delaying cavitation than in high prevalence era. Such fact made it rather difficult for different examiners to diagnose caries. Dentists may agree on the presence of a carious lesion when it is well established and obvious to the naked eye, but they might will sometimes disagree with each other when examining a surface which may bear an early lesion, making it difficult for them to diagnose and treat carious lesions. The main diagnostic tools today are the still mirror, light, explorer and the radiographic examination. However, new technology has been developed for this purpose. Therefore the aim of the present work was: 1) to verify the agreement of a group of dentists on dental treatment and diagnostic decisions and to calculate the probable costs related to the treatment; 2) to evaluate " in vitro " the accuracy and reproducibility of the following methods: clinical, videoscope, FOTI, and a fluorescent laser device (Diagnodent® -Kavo) for the diagnosis of occlusal caries, using the histologic exam as validation; 3) to compare "in vivo" the performance of the clinical, FOTI and radiographic exams with that of the direct visual exams, for the diagnosis of dental caries on approximal surfaces. Within the experimental conditions of these study, it was verified that: 1) there was a wide variation in the diagnosis and indication of caries treatment for occlusal surfaces as well as in the cost of the treatment suggested by the dentists; 2) the visual, videoscope and FOTI exams presented low sensitivity but high specificity values for the diagnosis of occlusal surfaces. The laser DIAGNOdent® presented high sensitivity values but at the expense of great number of false positive diagnoses 3) the radiographic exam showed the best accuracy for the diagnosis of noncavitated and cavitated caries lesions in comparison with the clinical and FOTI examsMestradoCariologiaMestre em Odontologi

Monoclonal antibodies against sporangia and spores of Marteilla sp. (Protozoa: Ascetospora)

6 pages, 4 figures.Digestive glands of mussels Mytilus edulis from Brittany, France, infected with Marteilia sp. (Ascetospora) were used to purify the parasite. A modification of a previously used punfication protocol increased purification efficiency, permitting sporangial primordia and sporangia of Marteilia sp. to be obtained. Mouse (Balb/c) monoclonal antibodies were generated against this parasite. From the fusion, 26 monoclonal antibodies against Marteilia sp. were obtained. Antibodies from 6 clones reacted only with Marteilia sp. cells and not with normal host tissues. Four of these antibodies (1/1-3, 3/1-1, 4/1-1 and 6/2-3) reacted with the sporangia wall and two with the spore cytoplasm (9/1-1 and 12/5-1), Antibodies cross-reacted with Marteilia refringens from Mytilus galloprovincialis obtained in the Ría de Vigo, Spain.J.A.F.R. acknowledges Xunta de Galicia, Spain, for his with research fellowship at the IIM-CSIC and Caixa Galicia for his research fellowship at IFREMER - La Tremblade.Peer reviewe