https://tedebc.ufma.br/jspui/handle/tede/1283 2026-04-14T17:29:12Z https://tedebc.ufma.br/jspui/handle/tede/6842 Título: EXPLORANDO CONEXÕES ENTRE ALTERAÇÕES ÓSSEAS DEGENERATIVAS E INFLAMATÓRIAS E AS PATOLOGIAS PULPO-PERIAPICAIS Autor: SILVA, Ana Paula Nóbrega Caetano da Primeiro orientador: SOUZA, Soraia de Fátima Carvalho Abstract: Introduction: Pulpo-periapical pathologies are chronic inflammatory diseases with high global prevalence, mostly resulting from the progression of untreated dental caries. Beyond their local impact, these conditions contribute to the individual's systemic inflammatory burden. Conversely, systemic disorders affecting bone metabolism may modulate the host response to these oral infections. This dissertation investigated the connections between two classes of systemic bone alterations: one degenerative (osteoporosis) and the other inflammatory (rheumatic autoimmune diseases), and pulpo-periapical pathologies. The objectives were to assess the evidence regarding: 1) the association between osteoporosis and the occurrence of pulpo-periapical pathologies; and 2) the association between rheumatic autoimmune diseases and the occurrence of pulpo-periapical pathologies. Methods: This dissertation comprises two systematic reviews and meta-analyses, following the PRISMA 2020 recommendations. Comprehensive searches were conducted in MEDLINE/PubMed, Embase, Scopus, BVS-Bireme, Web of Science, SciELO, and Cochrane Library databases, as well as in the grey literature. Observational studies (cross-sectional, cohort, and case-control) comparing the occurrence of pulpo-periapical pathologies in individuals with osteoporosis (first study) or rheumatic autoimmune diseases (second study) versus healthy control groups were included in both studies. Data were extracted by independent reviewers. Risk of bias was assessed using the Joanna Briggs Institute (JBI) tool, and the certainty of evidence was evaluated using the GRADE system. Meta-analyses were conducted using random-effects models to calculate Odds Ratios (OR) with 95% Confidence Intervals (95% CI). Results: In the first study (Chapter II), the random-effects meta-analysis of six studies identified no significant association between osteoporosis and the presence of pulpo-periapical pathologies (unadjusted OR= 1.65; 95% CI: 0.80 to 3.41; I²=98.5%). The result remained insignificant in the adjusted analysis (OR= 1.96; 95% CI: 0.68 to 5.66). In the second study (Chapter III), the random-effects meta-analysis of thirteen studies demonstrated a positive and significant association between rheumatic autoimmune diseases and pulpo-periapical pathologies. This association was found in both the patient-level analysis (adjusted OR= 1.60; 95% CI: 1.20 to 2.12; I²=95.2%) and the tooth-level analysis (unadjusted OR= 1.74; 95% CI: 1.28 to 2.37; I²=69.4%). In both reviews, the certainty of evidence was classified as "Very Low" (GRADE), mainly due to the high risk of bias in primary studies, high heterogeneity, and imprecision of results. Conclusion: The findings of this dissertation regarding the investigated outcomes yielded contrasting results: in the first study (Chapter II), the systematic review and meta-analysis showed no association between osteoporosis (a degenerative condition) and pulpo-periapical pathologies; however, in the second study (Chapter III), a positive association was observed with rheumatic autoimmune diseases (inflammatory conditions). The biological plausibility of this result suggests the need for an integrated clinical approach for the prevention of pulpoperiapical pathologies in individuals with rheumatic autoimmune diseases. Furthermore, we suggest future longitudinal studies with greater methodological rigor to elucidate possible connections between osteoporosis and endodontic outcomes. Instituição: Universidade Federal do Maranhão Tipo do documento: Dissertação 2026-01-29T00:00:00Z https://tedebc.ufma.br/jspui/handle/tede/6831 Título: IMPACTO DA MODELAGEM ADESIVA E DO TIPO DE LUVA NAS PROPRIEDADES MECÂNICAS DE UMA RESINA COMPOSTA: Um Estudo In Vitro Autor: TRINTA, Luana Barbieri Primeiro orientador: LAGO, Andréa Dias Neves Abstract: Restorative materials, such as composite resins, are widely used due to their esthetics, functionality, and preservation of dental structure. Their properties include strength, homogeneity, and ease of handling; however, these characteristics can be compromised by contamination during manipulation. Handling techniques vary according to the material's features, and the use of adhesives as lubricants and/or digital modeling can negatively impact the longevity of restorations due to the formation of defects at the adhesive interface. This study aimed to evaluate the influence of physical-mechanical properties of composite resins manipulated with latex and latex-free gloves, followed by modeling with two different adhesive systems. Nine groups were evaluated: (G1) Control group, (G2) Conventional adhesive group, (G3) Universal adhesive group, (G4) Latex gloves group, (G5) Latex gloves + conventional adhesive group, (G6) Latex gloves + universal adhesive group, (G7) Nitrile gloves group, (G8) Nitrile gloves + conventional adhesive group, and (G9) Nitrile gloves + universal adhesive group. Flexural strength, elastic modulus, water sorption, and Vickers microhardness were assessed. The results revealed that manipulation with adhesives significantly altered the physicochemical properties of the composites, except for water sorption and solubility tests, which showed no statistical variations among groups (). In the flexural strength test, group G9 (Nitrile + Universal Adhesive) showed the best median performance, while G3 (Universal Adhesive alone) exhibited the lowest values. Regarding the elastic modulus, groups G6, G7 and G9 demonstrated higher stiffness, whereas G2 presented the lowest stability. Vickers microhardness was severely negatively impacted in groups G2 and G3, evidencing that the use of adhesives as modelers, regardless of the glove type, reduces surface hardness. It is concluded that digital manipulation with nitrile gloves, especially when associated with universal adhesive, presents superior performance compared to latex manipulation, whose residues and sulfides tend to compromise the polymerization and the final mechanical strength of the resin. Instituição: Universidade Federal do Maranhão Tipo do documento: Dissertação 2025-01-20T00:00:00Z https://tedebc.ufma.br/jspui/handle/tede/6696 Título: Associação entre tipo de chupeta e comportamentos de sucção e amamentação em bebês a termo: um estudo transversal comparativo Autor: CORRÊA, Anna Raphaela de Souto da Costa Santos Campos do Couto Primeiro orientador: PEREIRA, Alex Luíz Pozzobon Abstract: This cross-sectional study aimed to compare sucking and breastfeeding behaviors in full-term babies by observing breastfeeding according to the type of pacifier used. Assessed 351 children treated at a human milk bank (HMB) at a university hospital in northeastern Brazil. The mothers were interviewed about the use of artificial nipple and breastfeeding was evaluated using the B-R-E-A-S-Tfeeding Observation Form recommended by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF). The following items where observated: position, response, affectivity, anatomy and suction. Children were divided into three groups according to pacifier use: 292 without pacifier use, 42 using conventional pacifiers and 17 using orthodontic pacifiers. Statistical analysis included Chi-square or Fisher's exact tests for categorical variables, and one-way ANOVA and Tukey post-hoc tests for continuous variables adopting a significance level of 5%. As result, the group of babies using orthodontic pacifiers obtained higher scores for favorable breastfeeding behaviors and lower scores for unfavorable, agreeing with the hypothesis that orthodontic pacifiers generate less negative impact on breastfeeding compared to conventional ones. The findings suggest that children who use pacifiers have more problems with grip, position, affectivity and sucking when compared to the group that opts for exclusive breastfeeding (EB) and reinforce the importance of guidance for families about the impact of the use of artificial nipples on the breastfeeding pattern. Instituição: Universidade Federal do Maranhão Tipo do documento: Dissertação 2023-07-07T00:00:00Z https://tedebc.ufma.br/jspui/handle/tede/6690 Título: AUTOPERCEPÇÃO E ATITUDES SOBRE O CONHECIMENTO ORTODÔNTICO PRÉ-PROTÉTICO: Uma análise com especialistas em reabilitação oral no Brasil Autor: BARROS, Vinícius de Paula Nascimento Primeiro orientador: PEREIRA, Alex Luiz Pozzobon Abstract: Introduction: Pre-prosthetic orthodontics is an important interdisciplinary treatment option, as it aims to optimize prosthetic-rehabilitation procedures. This type of treatment involves specific techniques for complex and difficult-to-resolve cases, integrating mechanics to re-establish the correct occlusal plane. Evidence suggests that improving orthodontic knowledge among professionals can help in decision-making and perception of orthodontic treatment, resulting in greater satisfaction for both the patient and the professional in relation to clinical cases. Objectives: To analyze the self-perceived knowledge of specialists in Prosthodontics, Implant Dentistry and Restorative Dentistry regarding the orthodontic approach prior to prosthetic rehabilitation treatment, as well as their attitudes towards interdisciplinary planning. Methods: This is a cross-sectional study conducted with specialists from all regions of Brazil (North, South, Northeast, Southeast and Midwest), using a structured questionnaire with sociodemographic questions and questions related to self-perception and attitudes about preprosthetic orthodontic knowledge, through direct and indirect virtual invitations. Descriptive statistical analysis included the calculation of absolute and percentage frequency measures and the construction of bar charts. The Chi-square (χ²) test or Fisher's exact test were applied to compare the frequencies of categorical variables between the groups. The significance level adopted for all analyses was 5% (P < 0.05). Results: A total of 351 participants answered the questionnaire independently, with 43.9% specializing in Prosthodontics, 35.9% in Implant Dentistry and 20.2% in Restorative Dentistry. Of these, 61.3% reported not having received content on orthodontics during their specialization course. With regard to pre-prosthetic orthodontics, 98.3% considered it to be favorable for the prognosis of rehabilitation treatments, and 93.4% reported that they noticed many flaws in the planning of patients with unfavorable occlusal relationships. The degree of patient satisfaction, as perceived by the professionals, was 8.5% in the “totally satisfied” category for cases without previous orthodontics, rising to 48.7% for cases with previous orthodontics (P <0.001). In addition, 70.1% reported that previous orthodontics favored rehabilitative treatment for partially or totally edentulous patients. Conclusion: In light of the above, specialists have a positive self-perception and favorable attitudes towards pre-prosthetic orthodontic knowledge. The mechanics of slow extrusion and space adaptation are the best known, compared to the mechanics of deep bite correction and root angulation. Clinical partnerships with orthodontists tend to optimize the results of rehabilitation procedures, promoting a better prognosis and patient satisfaction. Instituição: Universidade Federal do Maranhão Tipo do documento: Dissertação 2024-12-10T00:00:00Z