Evaluation of low-level laser therapy in patients with acute and chronic temporomandibular disorders.

The purpose of this study was to address the following question: among patients with acute or chronic temporomandibular disorders (TMD), does low-level laser therapy (LLLT) reduce pain intensity and improve maximal mouth opening? The sample comprised myogenic TMD patients (according Research Diagnostic Criteria for TMD). Inclusion criteria were: male/female, no age limit, orofacial pain, tender points, limited jaw movements and chewing difficulties. Patients with other TMD subtypes or associated musculoskeletal/rheumatologic disease, missing incisors teeth, LLLT contra-indication, and previous TMD treatment were excluded. According to disease duration, patients were allocated into two groups, acute (<6 months) and chronic TMD (≥ 6 months). For each patient, 12 LLLT sessions were performed (gallium-aluminum-arsenide; λ = 830 nm, P = 40 mW, CW, ED = 8 J/cm(2)). Pain intensity was recorded using a 10-cm visual analog scale and maximal mouth opening using a digital ruler (both recorded before/after LLLT). The investigators were previously calibrated and blinded to the groups (double-blind study) and level of significance was 5% (p < 0.05). Fifty-eight patients met all criteria, 32 (acute TMD), and 26 (chronic TMD). Both groups had a significant pain intensity reduction and maximal mouth opening improvement after LLLT (Wilcoxon test, p < 0.001). Between the groups, acute TMD patient had a more significant pain intensity reduction (Mann-Whitney test, p = 0.002) and a more significant maximal mouth opening improvement (Mann-Whitney test, p = 0.011). Low-level laser therapy can be considered as an alternative physical modality or supplementary approach for management of acute and chronic myogenic temporomandibular disorder; however, patients with acute disease are likely to have a better outcome.

Polimorfismos genéticos e o insucessodos implantes dentários: estudo piloto / Genetic polymorphism and failure ofdental implants: a pilot study

Objetivo: verificar a relação entre polimorfismos genéticos ligados às citocinas da remodelação óssea osteoprotegerina (OPG) e o ligante do ativador do receptor do fator nuclear kappa ß(RANKL), além de relacionar a presença de polimorfismos em OPG e RANKL com o insucesso clínico dos implantes dentários ao longo do tempo e determinar quais combinações de polimorfismos de OPG e RANKL estão associados ao insucesso de implantes dentários. Métodos: vinte pacientes, de ambos os sexos, maiores de 18 anos, reabilitados com 34 implantes dentários, foram avaliados por um período de 24 meses após a instalação das coroas sobre implantes. Após os exames clínico e radiográfico, os pacientes foram incluídos no grupo de insucesso dos implantes caso um ou mais do seguintes critérios fossem encontrados: mobilidade, queixas subjetivas persistentes, infecção peri-implantar recorrente com supuração, radiolucência contínua ao redor do implan- te, profundidade de sondagem ≥ 5mm e sangramento à sondagem. Foi coletado sangue periférico para a análise do polimorfismo das citocinas OPG e RANKL por meio da reação em cadeia da polimerase (PCR). Resultados: não houve diferença estatisticamente significativa entre o grupo de falha dos implantes em relação aos genótipos de OPG e RANKL. Conclusão: os polimorfismos de OPG e RANKL não influenciaram no insucesso dos implantes dentários na amostra avaliada.

Objective: To investigate the relationship between genetic polymorphisms related to cytokinesin bone remodeling osteoprotegerin (OPG) and receptor activator of nuclear factor kappa ß ligand (RANKL). It also aims to relate the presence of OPG and RANKL polymorphisms with clinicalfailure of dental implants over time and to determine which combinations of OPG and RANKL polymorphisms are associated with failure of dental implants. Methods: Twenty patients of both sexes, over eighteen years, rehabilitated with thirty-four dental implants were evaluated during 24months after implant-supported crown placement. After clinical and radiographic examination, patients were included in a failure group if one or more of the following criteria were identified: mobility, persistent subjective complaints, recurrent peri-implantitis with suppuration, continuous radiolucency around the implant, probing depth ≥ 5 mm and bleeding on probing. Peripheral blood was collected for analysis of cytokine OPG and RANKL polymorphisms by polymerase chain reaction (PCR). Results: There were no statistically significant differences between the failure group in relation to genotypes OPG and RANKL. Conclusion: OPG and RANKL polymorphisms didnot influence dental implants failure in the investigated sample.

Implantes dentários imediatos e em carga imediata / Immediate placed and immediate loaded implants. A literature review

A evolução da Implantodontia vem trazendo o desenvolvimento de novas técnicas, que levam cada vez mais conforto ao paciente, seja pelo fato de menos intervenções cirúrgicas com o implante imediato, seja pelo menor tempo que ele passe desdentado, pela técnica da carga imediata. O implante imediato é utilizado, geralmente, logo após a realização de exodontia, para que futuramente seja colocada a prótese. Sua principal vantagem é de redução das etapas cirúrgicas e de evitar a reabsorção óssea, principalmente em áreas estéticas. O uso da carga imediata em implantes tem a finalidade de reduzir o tempo de tratamento, possibilitando que o procedimento protético seja realizado logo após a colocação do implante, porém, o cirurgião-dentista deve saber indicar adequadamente a sua aplicação, seguindo todos os critérios necessários para evitar que ocorram insucessos do tratamento. Este trabalho teve por objetivo revisar a literatura acerca de dois métodos de instalação de implantes, de carga imediata e imediatos, que visem reduzir o tempo de espera pela prótese por parte dos pacientes e apontar suas principais indicações e contraindicações.

he evolution of dental implants has led to the development of new techniques that bring more comfort to the patient, either by the need for fewer surgical interventions with the immediate implant or by the short time period patients spent toothless on immediate loading. The immediate implant is used soon after tooth extraction for prosthesis delivery. Its advantages include reduction of surgical steps and bone resorption, particularly in esthetics areas. The use of immediate loading is intended to reduce overall treatment time, allowing prosthetic installation immediately after implant placement; however, proper indications are necessary as well as the correct protocol for preventing the incidence of treatment failures. This paper aims to review the literature on these two methods for implant placement (immediate implants and immediate loading) which reduce time until prosthesis delivery, highlightening their main indications and drawbacks.