Técnicas de alongamento coronário

Introdução: O alongamento coronário é um procedimento que pode envolver, ou não, técnicas cirúrgicas, e que tem como principal objetivo aumentar o tamanho da coroa clínica, assim como devolver a estética, a forma e a função às arcadas dentárias. Este procedimento realiza-se, ou por motivos estéticos ou motivos restauradores. Ultimamente, os motivos estéticos têm vindo a ganhar importância e são eles que, muitas da vezes, levam os pacientes às consultas de medicina dentária. O sorriso gengival é um desses motivos, e pode ser causado, entre outras razões por, uma erupção passiva alterada ou/e um excesso vertical maxilar. Estas são as etiologias que serão descritas neste trabalho. O aumento coronário realiza-se, também, quando há a necessidade de reabilitar um dente, quer seja com resinas compostas ou com coroas. Este, deve sempre respeitar os limites biológicos do periodonto, nomeadamente o espaço biológico. A invasão deste espaço pode por em risco a manutenção da saúde do periodonto e a viabilidade do tratamento a longo prazo, por isto, preconiza-se que deve ser deixado um espaço de 3mm, desde a crista óssea até a margem restauradora. As técnicas de alongamento coronário enumeradas e definidas ao longo desta tese são: a gengivectomia, o retalho apicalmente posicionado e a erupção dentária forçada. Cada uma delas possui as suas indicações e contra-inidcaçoes. A gengivectomia é realizada quando não há necessidade de recontorno ósseo, pelo contrário, quando essa necessidade existe opta-se pelo retalho apicalmente posicionado. A erupção forçada é uma alternativa ao alongamento cirúrgico e aplica-se, normalmente a dentes não restauráveis mas com estrutura dentária sã abaixo do da crista óssea. Um ótimo diagnóstico é o essencial para a escolha da técnica de aumento coronário que melhor se adequa a cada caso. Objetivo: O objetivo desta revisão bibliográfica tem por base a pesquisa das técnicas de alongamento coronário, começando por perceber a anatomia do periodonto, as alterações que nele acontecem antes e depois dos procedimentos de alongamento coronário, a descrição e a comparação dos mesmos. Materiais e métodos: Para a realização desta revisão foram utilizados os principais motores de busca de dados científicos como a PubMed, B-on, Medline, Scielo, Google Académico e ainda o repositório on-line da Universidade Fernando Pessoa. Foram utilizadas as seguintes palavras chaves: “altered passive eruption”, “gingivectomy”, “gingivoplasty”, “apically repositioned flap”, “surgical crown lengthening”, “biologic width”, “mucogengival junction”, “forced eruption”, “prostethic dentistry”, “gummy smile”, resultando num pesquisa de 45 artigos e duas obras literarátias de interesse. Conclusões: Foi possível concluir que existem varias técnicas de alongamento coronário, cada uma adequada a cada caso e verificou-se que existem vários motivos pelo qual se realiza essa técnica.

Socket-shield and immediate implantation

Introduction - After tooth extraction, the alveolar bone undergoes a remodeling process, wich leads to horizontal and vertical bone loss. These resorption processes complicate dental rehabilitation, particularly in connection with implants. Various methods of guided bone regeneration have been described to retain the original dimension of the bone after extraction. Most procedures use filler materials and membranes to support the buccal plate and soft tissue, to stabilize the coagulum and to prevent epithelial ingrowth. It has also been suggested that resorption of the buccal bundle bone can be avoided by leaving a buccal root segment (socket-shield technique) in place, because the biological integrity of the buccal periodontum remains untouched. This method has also been decribed in connection with immediate implant placement. Objective - This literature review aim enumerate and describe the different treatments and tissue reactions after tooth extraction, immediate and delayed implantation. The socketshield technique, the evolution in tooth extraction and immediate implantation with high esthetic results due to the preservation of hard and soft tissues by leaving a buccal root segment in place. Materials and methods - For this purpose a research has been done and data was obtained from on-line resources: Medline, Pubmed, Scielo, Bireme, Bon, books and specialized magazines which was conducted between January 2016 and May 2016. A number of articles have been obtained in English and French ,published between 1997 and 2015 . The key words used were implantology, dental implant, hard/soft tissue, tooth extraction, immediate implantation, delayed implantation, socket-shield. Conclusion - In socket-shield technique, there were neither functional nor aesthetic changes in soft and hard tissues. It’s already a routine practice in the arsenal of highaesthetic immediate implantology and should be used when indicated. Although this technique is quiet promising, we should be aware of the incoming publications about a larger follow up and the predictability of leaving a fragment inside the socket after an extraction.

Cholecystectomy by single incision laparoscopic surgery (SILS): early experience and technique standardization

Single Incision Laparoscopic Surgery (SILS) is a recent surgical technique, first described in the 1990s. Its aim is to optimize the esthetic result offered by laparoscopy by minimizing the number of abdominal incisions. Various preliminary studies have been carried out on the application of SILS, especially in cholecystectomy and appendectomy. This study evaluates the preliminary results of cholecystectomy by SILS (SILS™ Port) conducted between October 2009 and February 2011 on 21 patients (4 men and 17 women) with a mean age of 49.9 years and a mean Body Mass Index (BMI) of 22.8. All patients were treated by the same team, which had previously undergone six months’ simulator training. There were two main selection criteria, both evaluated intraoperatively: absence of adhesions and of significant inflammatory sequelae from previous cholecystitis; and suitable distance between gallbladder and SILS access port. Conversion to traditional laparoscopy was necessary in just two cases, while an accessory trocar was introduced in another two cases. Conversion to open surgery was not necessary in any case. One case of SILS cholecystectomy was complicated by postoperative bile leakage, which was treated conservatively, as the fistula had a low output. The mean duration of hospitalization was 3.6 days. This preliminary experience led us to conclude that SILS is safe and highly satisfactory in the postoperative phase, thanks to the reduced need for painkillers and the improved esthetic result.

Indications for and limits of conservative surgery in breast cancer

Improvements in diagnostic techniques and, above all, breast cancer screening campaigns - essential for early diagnosis - have enabled the objectives of conservative surgery to be pursued: disease control, no or low incidence of recurrences and an excellent esthetic result. However, to reach these objectives, it is essential to ensure a careful evaluation of the medical history of every patient, a detailed clinical examination and the correct interpretation of imaging. Particular attention should be paid to all factors influencing the choice of treatment and/or possible local recurrence: age, site, tumor volume, genetic predisposition, pregnancy, previous radiotherapy, pathological features, and surgical margins. The decision to undertake conservative treatment thus requires a multidisciplinary approach involving pathologists, surgeons and oncological radiologists, as well, of course, as the patient herself.

O metal na arquitetura contemporânea paraibana 1990-2002

This essay studies about contemporary architecture in João Pessoa, capital city of Paraiba State, which analyzes the utilization of steel and aluminum materials from 1990 to 2002, period when significant increase of this utilization is seen. As references, the architectural analysis and Engel structures definitions were used to analyze 40 built buildings, universe researched, to bring together subsidies to comprehend the contemporary production, especially which use the metal as structural and esthetic-formal element

Trajetos cênicos do grupo parafolclórico da UFRN:que dança é essa?

This paper aims at studying UFRN Parafolclórico Group, whose aesthetic formation is subjected to our analysis, specially at its two last performances, that is, Flor do Lírio (Lily Flower), 2004, and Debaixo do Barro do Chão (Under the Mud of the Ground), 2008. Three targets are envisaged here: to analyze the aesthetic ideas backing Parafolclórico Group exhibitions; to evaluate how their many folk elements interact with different artist languages in order to compose a certain choreography; and finally, to identify the aesthetic conformation placed behind the two different choreographs of the last performances, their trends and innermost features that differentiate them. In accordance with the Analysis of Contents (BARDIN, 2006), interviews have been made with the choreographers and the staff of the spectacles, resulting in elucidating answers to the understanding of their thematic axis. On the first chapter we called attention to motivating subjects as recollection, personal experiences, bibliography research, research in loco regarded as propelling forces of the creative works. Herein, folk culture is depicted as a dynamic process opening a frank dialogue with contemporary events and reinforcing their continuity. On the second chapter, we approached the aesthetic conformation and the scenic elements (costumes, light, scenario, make-up), integrating the studied spectacles and disseminating folk songs in various ways. As what concerns the subjects discourse, we have obtained support in authors like Robatto (1994); Lobo; Navas (2008); Burke (1989); Canclini (2006); Dufrenne (2005); Medeiros (2005); Pavis (2005); Silva (2005), among others. Those authors have provided us with an indispensable theoretic support which, added to the interviews, convinced us that the Parafolclórico Group s aesthetic conception tends to identify itself with the artist languages and other techniques of that Group. It also made sure that the Group s course aims at an aesthetic conception which is not limited to popular culture manifestations, like dance, but admits to play with other media in order to communicate its art. In view of this situation, we arrived to two conclusions: first: the group s interchanges emphasize the dynamic character of popular culture which, by establishing contacts with different realities, receives influences capable of extending its own continuity; second: the contemporary state of arts also improves multiple interchanges opening way, so, for many accomplishments in their field. Therefore, UFRN Parafolclórico Group inserts itself in the contemporary scenery by performing new evaluations of the popular dances as long as it puts them in contact with different technical, aesthetic, artist and culture combinations

Filmowe interpretacje polskiej transformacji gospodarczej. Kulturowe spory o obraz Polski

Wydział Nauk Społecznych: Instytut Kulturoznawstwa

A contribuição da educação ambiental para uma compreensão ética da relação entre indivíduos humanos e cães: inferências teóricas a partir de um estudo de caso no município de Rio Grande-RS

A presente pesquisa teve como problemática o cão abandonado, e fez a relação entre esta situação e os processos humanos e culturais que perpassam o problema. A questão central da pesquisa é: Como compreender a relação dos humanos com os cães, e como a Educação Ambiental pode contribuir para a construção da reflexão sobre o tema e a consequente mudança de postura dos humanos para com estes animais em seu convívio social? O foco da pesquisa é a ética entendida como ética da vida a partir de autores como Morin, Singer e Brugger. O objetivo da pesquisa é contribuir para a construção de uma nova mentalidade; fazer perceber uma ética que não está clara, e buscar compreender os processos que afastem os humanos desta mentalidade. Sendo assim, a fundamentação teórica concentra - se em estudos sobre a ética, a domesticação e o antropocentrismo. Justifico este trabalho por tratar de uma situação degradante para com a vida deste animal, por seu valor intrínseco, e por ser um animal que, em minha opinião, acompanhou e refletiu a própria história da humanidade. A metodologia utilizada foi o Estudo de Caso, aplicado na cidade de Rio Grande, entre 2011 e 2013, e contou com entrevistas com grupos de proteção animal, e com o atual prefeito municipal. Como ferramenta metodológica, para a realização da pesquisa e do texto, utilizei a Mandala Reflexiva, da Prof. Dra. Virginia Machado, que é uma configuração de abordagem pedagógica e epistemológica do processo de investigação. A interação da pesquisa, além do resultado da atividade com alunos jovens e adultos da 8ª série do PROMEJA de uma escola municipal, envolveu a proposta da produção de vídeos amadores de sensibilização sobre o tema, para ser aplicada em escolas ou em quaisquer tipos de projetos com interessados sobre o tema, a fim de difundir a questão a partir da experiência ético - estética. O resultado prático é o registro de uma nova expectativa em relação à resolução do problema dos cães abandonados nesta cidade. Filosoficamente, chegou - se a uma reflexão complexa sobre o ser humano e suas ações no planeta, que indicam que, quanto mais formos capazes de pensar no todo, e substituir o egoísmo por uma dosagem de altruísmo e de ética, mais sentido terá a nossa própria vida.

Construção de uma Comunidade de Práticas para a Promoção da Leitura

Trabalho de projeto apresentado à Escola Superior de Educação de Paula Frassinetti para obtenção do grau de Mestre em Ciências da Educação Especialização em Animação da Leitura

Mastectomia e corporalidade: impacto da cirurgia estético-reconstrutiva

Dissertação de Mestrado apresentada no Instituto Superior de Psicologia Aplicada para obtenção de grau de Mestre na especialidade de Psicologia Clínica,

Perspectives esthétique et compositionnelle d’une dialectique entre le son et la musique

Visant à contribuer à la pérennité de la musique d’art instrumentale, cette thèse aborde plusieurs sujets la concernant, autant sur les plans théorique et esthétique que pratique et compositionnel. Les deux principaux contextes observés sont ceux de la modernité et de l’économie de marché. Le premier, par le triomphe de la raison technicienne, aurait conduit à l’autonomie de l’art désormais confronté aux risques de l’autoréférence. Le deuxième, par la pression exercée sur le compositeur à la base de la chaîne création-production-diffusion, compromettrait cette autonomie qu’elle avait pourtant contribuée à rendre possible. Or, l’autonomie de l’art, en tant que conquête sur les plans esthétique, social, politique, économique et intellectuel, représente un enjeu de taille, puisque d’éventuelles compromissions envers des impératifs extérieurs impliquent un recul sur tous ces plans. Pour répondre à cette problématique, la thèse explore des pistes de réflexions et d’opérations pour réaffirmer – en le revendiquant – ce que la musique d’art possède en propre et qui mérite encore d’être entendu, militant ainsi pour la survie de ce qui la rend possible. Plus précisément, la dialectique du son et de la musique que je développe ici me permet, dans un premier temps, d’aborder les médiations successives conduisant des ondes mécaniques à se structurer dans notre conscience jusqu’à se transmettre à nous sous forme de patrimoine; puis, dans un deuxième temps, de décrire ma propre intention de communication par la musique en analysant deux œuvres de ma composition : Musique d’art pour quintette à cordes et Musique d’art pour orchestre de chambre II (partie 1.). Musique d’art pour quintette à cordes est une œuvre-concert de soixante-cinq minutes pour quatuor à cordes et contrebasse, spatialisation, traitement et mise en espace des musiciens. Il s’agit d’un projet de recherche-création de mon initiative que j’ai aussi mené à titre de producteur. Musique d’art pour orchestre de chambre II (partie 1.) est une œuvre de commande de quatorze minutes. Le retour critique portant sur l’ensemble des composantes caractéristiques du média ouvre la voie à une corrélation plus étroite entre son contenu et sa forme privilégiée de présentation, le concert. Cette corrélation peut amener le public à désirer visiter les œuvres et apprécier leur signification, préservant la musique d’art comme mode spécifique de connaissance du monde.

O romance histórico da colonização : a figuração artística transgressiva do passado em O tetraneto del-rei, de Haroldo Maranhão, A gloriosa família, de Pepetela, e As naus, de António Lobo Antunes

Tese (doutorado)—Universidade de Brasília, Instituto de Letras, Instituto de Letras, Departamento de Teoria Literária e Literaturas, Programa de Pós-Graduação em Literatura, 2016.

Evaluation of Onlay Island Flap Technique in Shallow Urethral Plate Hypospadiasis

Background: Hypospadias is one of the most common congenital genital anomalies in males that necessitates to be operated early in infancy (when 6 to 9 months old). On the other hand, hypospadias is a challenging field of pediatric urology with multiple reconstruction techniques. A perfect hypospadias repair is supposed to return urethral continuity with sufficient caliber, eradicate phallus curvature, and supply an acceptable appearance with low complications. Objectives: This study aimed to evaluate the outcomes of using onlay island flap technique in the repair of hypospadias with shallow urethral plate. Patients and Methods: In this prospective study within June 2012 to December 2013, we performed onlay island flap procedure to repair hypospadias with shallow urethral plate measuring less than 6 millimeter. This technique was selected for all types of hypospadiasis except subcoronal type. Nesbit’s dorsal plication procedure was established for chordee. In cases with very small glans, urethroplasty was performed without glansplasty. Results: Twenty three patients with mean age of 30 (range 10 - 60) months underwent onlay island flap repair; all had a shallow urethral plate < 6 mm, 3 had a very small glans, and 18 had chordee. Meatus was located in distal shaft in 5 cases, mid shaft in 8, proximal in 6 and penoscrotal type in 4 patients. Chordee was corrected with Nesbit’s dorsal plication in 16 cases. Complications were: meatal stenosis in 2 cases and urethrocutaneous fistula in 2 patients, all of which were repaired surgically. Mean follow up time was 13 (3 - 20) months. All cases that had glansplasty have excellent esthetic appearance. Conclusions: This technique offers acceptable results regarding meatal stenosis, urethrocutaneous fistula and esthetic outcome.

El Señor Presidente y el vanguardismo surrealista

El Señor Presidente es un texto vanguardista, no según la modalidad europea, sino según la vertiente híbrida surgida en América Latina. La novela utiliza recursos y estrategias discursivas del surrealismo para redimensionar las experiencias subjetivas de unos personajes envueltos por la atmósfera pesadillesca y demoníaca de la dictadura. Como texto híbrido mezcla lo ajeno (vanguardias europeas y cristianismo) y lo propio (cultura maya-quiché); y su confluencia posibilita la colisión de tres estéticas: la corriente realista (realismo y regionalismo), el mundo animista maya-quiché y las vanguardias (surrealismo).El Señor Presidente is a vanguard text, not in the European sense, but following the hybrid form appearing in Latin America. The novel employs resources and discourse strategies of surrealism to resize the subjective experiences of some characters enveloped in the nightmarish and demonic atmosphere of the dictatorship. As a hybrid text, foreign aspects (European vanguards and Christianity) are combined with their own (Mayan-Quiche culture); and their coming together leads to the collision of three esthetic codes: realist currents (realism and regionalism), the animist Mayan-Quiche world and the vanguards (surrealism).

The influence of rock fabric in the durability of two sandstones used in the Andalusian Architectural Heritage (Montoro and Ronda, Spain)

Natural stone has been a popular and reliable building material throughout history appearing in many historic monuments and in more recent buildings. Research into the intrinsic properties of specific stones is important because it gives us a greater understanding of the factors that limit and act on them. This can help prevent serious problems from occurring in our buildings bringing both esthetic benefits and financial savings. To this end, the main objective of this research has been to study the influence of the fabric and the mineral composition of two types of sandstone on their durability. The first is a red continental sandstone from the Buntsandstein Age called “Molinaza Roja”, which is quarried in Montoro (Cordoba). The second is quarried in Ronda (Malaga) and is sold under the trade name of “Arenisca Ronda”. It is a light pink-whitish calcarenite deposited during the Late Tortonian to Late Messinian. We characterized their petrological and petrophysical properties by studying their rock fabrics, porous systems and mechanical properties. In order to obtain a complete vision of the behavior of their rock fabrics, we also carried out two decay tests, the salt crystallization and the freeze–thaw tests. We then measured the effects on the textures of the altered samples during and after the decay tests and we evaluated the changes in the porous system. By comparing the results between intact and altered samples, we found that Arenisca Ronda is less durable because it has a high quantity of expandable clays (smectites) and a high percentage of pores in the 0.1–1 μm range, in which the pressure produced by salt crystallization is strongest. In Molinaza Roja the decay agents caused significant sanding due to loss of cohesion between the clasts, especially during the salt crystallization test. In both stones, the anisotropies (oriented textures) have an important role in their hydric and dynamic behavior and also affect their mechanical properties (especially in the compression resistance). No changes in color were detected.