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Master's Dissertation
DOI
Document
Author
Full name
Letícia Sgarbi Pinto
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
Ribeirão Preto, 2018
Supervisor
Committee
Nelson Filho, Paulo (President)
Andrucioli, Marcela Cristina Damião
Pinto, Ary dos Santos
Romano, Fábio Lourenço
Title in Portuguese
Ligaduras ortodônticas elastoméricas estéticas: quantificação de endotoxina bacteriana in vitro e in vivo
Keywords in Portuguese
Elastômeros
Endotoxinas
Ligadura
Lipopolissacarídeos
Ortodontia
Teste do Limulus
Abstract in Portuguese
O objetivo do presente trabalho foi quantificar, in vitro e in vivo, a endotoxina bacteriana (LPS) aderida a ligaduras ortodônticas elastoméricas estéticas de poliuretano e de silicone, empregando o teste Limulus Amebocyte Lysate (LAL). Para o estudo in vitro foram utilizadas quatro tipos de ligaduras elastoméricas estéticas: Sani-Ties (poliuretano) e Sili-Ties (silicone), da GAC, e Mini Single Case Ligature Stick (poliuretano) e Synergy® Low-friction ligatures (silicone), da Rock Mountain, sendo 5 contaminadas com solução de endotoxina (controle positivo) e 5 não-contaminadas (controle negativo). Réplicas feitas de fio de amarrilho torcido e de aço inox fundido, de mesmo tamanho e formato das ligaduras elastoméricas, contaminadas ou não com endotoxina, foram usadas como controle. A quantificação de endotoxina foi realizada por meio do teste LAL (Kit QCL-1000™), sendo os resultados expressos em unidades de endotoxina (UE/mL). No estudo in vivo, 20 pacientes de ambos os gêneros, com faixa etária entre 15 e 30 anos, que iniciaram tratamento com aparelho ortodôntico fixo na Faculdade de Odontologia de Ribeirão Preto - Universidade de São Paulo receberam, randomicamente, em quadrantes alternados, os mesmos quatro tipos de ligaduras elastoméricas utilizadas no estudo in vitro, sendo uma ligadura de cada marca inserida nos caninos superiores e inferiores (13, 23, 33 e 43), aleatoriamente. Vinte e um dias após, as ligaduras foram removidas e processadas para quantificação da endotoxina bacteriana, utilizando também o Kit QCL-1000™. Todos os dados obtidos foram submetidos à análise estatística apropriada de acordo com a distribuição dos dados, por meio dos testes de Kruskal-Wallis e pós-teste de Dunn (estudo in vitro) e ANOVA de medidas repetidas e pós-teste de Tukey (estudo in vivo). Todas as análises foram efetuadas por meio do programa Graph Pad Prism 4.0, com nível de significância de 5%. De acordo com os resultados obtidos, observou-se que a endotoxina bacteriana aderiu-se a todos os materiais testados. No estudo in vitro, o grupo GAC silicone foi o que apresentou menor mediana de contaminação (1,15 UE/mL), com relação aos outros grupos (p<0,0001), os quais não apresentaram diferença estatisticamente significante quando comparados entre si (p>0,05). No estudo in vivo, de maneira semelhante ao observado no estudo in vitro, o grupo GAC silicone foi o que apresentou menor média de contaminação (0,577±0,017 UE/mL), com diferença estatisticamente significante (p<0,001) em comparação aos demais grupos. Pôde-se concluir, que a endotoxina bacteriana apresentou afinidade pelas ligaduras elastoméricas estéticas à base de silicone e poliuretano testadas. As ligaduras de silicone da marca GAC foram as que apresentaram menor quantidade de endotoxina aderida às suas superfícies
Title in English
Orthodontic elastomeric aesthetic ligatures: quantification of bacterial endotoxin in vitro and in vivo
Keywords in English
Elastomers
Endotoxins
Ligation
Limulus test
Lipopolysaccharides
Orthodontics
Abstract in English
The objective of this study was to quantify, in vitro and in vivo, bacterial endotoxin (LPS) attached to esthetic elastomeric orthodontic ligatures made of polyurethane and silicone using the Limulus Amebocyte Lysate test (LAL). For the in vitro study, were used four types of aesthetic elastomeric ligatures: Sani-Ties (polyurethane) and Sili-Ties (silicone) - GAC, and Mini Single Case Ligature Stick (polyurethane) and Synergy® Low-friction ligatures (silicone) - Rock Mountain; 5 of each were contaminated with endotoxin solution (positive control) and 5 non-contaminated (negative control). Replicas made of twisted wire ligatures and of cast stainless steel, of the same size and shape than the elastomeric ligatures, contaminated or not with endotoxin, were used as control. Endotoxin quantification was performed using the LAL test (QCL-1000™ kit), the results being expressed in EU/mL. In the in vivo study, 20 patients of both genders, with ages ranging from 15 to 30 years old, who started treatment with a fixed orthodontic appliance at the School of Dentistry of Ribeirão Preto - University of São Paulo, received randomly the same four types of elastomeric ligatures used in the in vitro study, being a ligature of each brand inserted in the upper and lower canines (UR3, UL3, LR3, LL3), randomly. Twenty-one days later, ligatures were removed and processed for quantification of bacterial endotoxin, using the same test as the in vitro study. All data were submitted to appropriate statistical analysis according to the data distribution, using KruskalWallis tests and Dunn post-test (in vitro study) and ANOVA of repeated measurements and Tukey's post-test (in vivo study). All analyzes were performed using the Graph Pad Prism 4.0 program, with a significance level of 5%. According to the results obtained, it was observed that the bacterial endotoxin attached to all materials tested. In the in vitro study, the GAC silicone group had the lowest median contamination (1.15 EU/mL), in relation to the other groups (p<0.0001), which did not present a statistically significant difference when compared to each other (p>0.05). In the in vivo study, similar to that observed in the in vitro study, the GAC silicone group had the lowest mean contamination (0.577 ± 0.017 EU/mL), with a statistically significant difference (p< 0.001) compared to the others groups. It could be concluded that bacterial endotoxin exhibited affinity for the tested silicone and polyurethane aesthetic elastomeric ligatures. The silicone ligatures of GAC brand were the ones that presented less amount of endotoxin attached to their surfaces
 
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Publishing Date
2019-07-23
 
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