Photodynamic antimicrobial therapy (A-PDT) using 1,9-Dimethyl-Methylene Blue zinc chloride double salt - DMMB and λ640 ± 5ηm LED light in patients undertaking orthodontic treatment.

Orthodontic treatment involves the use of apparatuses that impairs oral hygiene making patients susceptible to periodontal diseases and caries. To prevent increased antimicrobial resistance A-PDT has shown itself a feasible option. The aim of this investigation was to assess the efficiency of A-PDT employing 1,9-Dimethyl-Methylene Blue zinc chloride double salt - DMMB as a photosensitizing agent combined with red LED irradiation (λ640 ± 5 ηm) against oral biofilm of patients undertaking orthodontic treatment. Twenty-one patients agreed to participate. Four biofilm collections were carried out on brackets and gingiva around inferior central incisors; first was carried out before any treatment (Control); second followed five minutes of pre-irradiation, the third was immediately after the first AmPDT, and the last after a second AmPDT. Then, a microbiological routine for microorganism growth was carried out and, after 24-h, CFU counting was performed. There was significant difference between all groups. No significant difference was seen between Control and Photosensitizer and AmpDT1 and AmPDT2 groups. Significant differences were observed between Control and AmPDT1 and AmPDT2 groups, Photosensitizer and AmPDT1 and AmPDT2 groups. It was concluded that double AmPDT using DMBB in nano concentration and red LED was capable to meaningfully decrease the number of CFUs in orthodontic patients.

Oral microbiological control by photodynamic action in orthodontic patients.

BACKGROUND: Orthodontics involves diagnosis and treatment of dental and skeletal malocclusions. Orthodontic apparatus may repair these malocclusions but may also impair oral hygiene making patients prone to develop both periodontal diseases and caries. Antimicrobial agents may be used to prevent this.To avoid increased antimicrobial resistance to available drugs, A-PDT (Antimicrobial Photodynamic Therapy) appears as a viable alternative. OBJECTIVE: This work aimed to evaluate the efficacy of A-PDT on reducing the number of colony forming units (CFU) through the use of phenothiazine compound (methylene blue+ toluidine blue) as a photosensitizer, associated with red LED (λ640±5ηm) irradiation in orthodontic patients. METHODOLOGY: Twenty-one patients consented to participate in the study. Three biofilm collections were performed around the brackets and gums of the inferior central incisors; first before any intervention (Control); second after 5min of pre-irradiation and the last one immediately after AmPDT. Subsequently, a microbiological routine for microorganism growth period were performed and CFU counting after a 24h done. RESULTS: The data showed that the AmPDT was able to reduce CFU count around 90% when compared to Control group (p=0.007) and also between the A-PDT and Photosensitizer groups (p=0.010). However, there were no differences between the Control and Photosensitizer groups. CONCLUSION: A-PDT associated with the use of phenothiazine compounds and red LED was able to significantly reduce the number of CFUs in orthodontic patients.

Vertical control in the Class III compensatory treatment.

INTRODUCTION: Compensatory orthodontic treatment, or simply orthodontic camouflage, consists in an important alternative to orthognathic surgery in the resolution of skeletal discrepancies in adult patients. It is important to point that, to be successfully performed, diagnosis must be detailed, to evaluate, specifically, dental and facial features, as well as the limitations imposed by the magnitude of the discrepancy. The main complaint, patient's treatment expectation, periodontal limits, facial pattern and vertical control are some of the items to be explored in the determination of the viability of a compensatory treatment. Hyperdivergent patients who present with a Class III skeletal discrepancy, associated with a vertical facial pattern, with the presence or tendency to anterior open bite, deserve special attention. In these cases, an efficient strategy of vertical control must be planned and executed. OBJECTIVE: The present article aims at illustrating the evolution of efficient alternatives of vertical control in hiperdivergent patients, from the use, in the recent past, of extraoral appliances on the lower dental arch (J-hook), until nowadays, with the advent of skeletal anchorage. But for patients with a more balanced facial pattern, the conventional mechanics with Class III intermaxillary elastics, associated to an accentuated curve of Spee in the upper arch and a reverse curve of Spee in the lower arch, and vertical elastics in the anterior region, continues to be an excellent alternative, if there is extreme collaboration in using the elastics.

Effect of laser phototherapy on the hyalinization following orthodontic tooth movement in rats.

OBJECTIVE: We aimed to assess histologic changes after the use of laser phototherapy (LPT) during induced tooth movement with 40 g/F on young adult male rats. BACKGROUND DATA: Hyalinization is a sterile necrosis at the pressure zone of the periodontal ligament observed during the initial stages of the orthodontic movement, and extensive hyaline areas might cause an important delay in the tooth movement. The use of LPT is considered an enhancement factor for bone repair, as it stimulates microcirculation as well as the cellular metabolism. MATERIALS AND METHODS: Thirty animals were divided into two groups (n=15), named according to the time of animal death (7, 13, and 19 days). Half of the animals in each group were subjected to irradiation with infrared (IR) laser (λ790 nm, round shaped beam, 40 mW, continuous wave (CW), diameter=2 mm (0.0314 cm(2)), 1.273 W/cm(2), time=2×112 sec+1×275 sec (total time 499 sec), 2×142.6/4.48 J+1×350/11 J, 635.2 J/cm(2)/20 J/ session), during orthodontic movement, the other half were used as nonirradiated controls. After animal death, specimens were sectioned, processed, and stained with hematoxylin and eosin (HE) and Sirius Red, and were used for semi-quantitative histologic analysis by light microscopy. Data were statistically analyzed. RESULTS: We demonstrated that LPT positively affected an important aspect of dental movement; the hyalinization. In the present study, we found a significant reduced expression of hyalinization after 19 days. On irradiated subjects, hyalinization was increased at day 7 with significant reduction at day 13. CONCLUSIONS: It is possible to conclude that the use of laser light caused histologic alterations during the orthodontic movement characterized by increased formation of areas of hyalinization at early stages, and late reduction when compared to nonirradiated animals.

Laser-induced alveolar bone changes during orthodontic movement: a histological study on rodents.

OBJECTIVE: The aim of this study was to assess by light microscopy changes in alveolar bone during orthodontic movement in rats. BACKGROUND: Orthodontic movement causes both removal and deposition of bone tissue. The use of laser phototherapy (LPT) is considered an enhancement factor for bone repair. METHODS: Thirty Wistar rats were divided into two groups (n = 15) and subdivided according to animal death (7,13, and 19 days). Half of the animals in each group were treated with LPT during orthodontic movement. After animal death, specimens were processed and underwent histological and semi-quantitative analyses (HE and Sirius red). RESULTS: LPT-irradiated specimens showed significantly higher numbers of osteoclasts when compared with controls at both 7 (p = 0.015) and 19 (p = 0.007) days, as well as significant increases in the number of osteoblasts (p = 0.015) between days 7 and 13. The amount of collagen matrix was significantly reduced between days 7 and 13 at both pressure and tension sites in controls (p = 0.015) but not in LPT-treated animals. LPT-treated subjects showed significantly greater deposition of collagen matrix at the pressure site at both the thirteenth (p = 0.007) and nineteenth days (p = 0.001). At the tension site, a significant increase in the amount of collagen matrix was observed in non-irradiated specimens (p = 0.048) between days 7 and 19. CONCLUSIONS: LPT caused significant histological changes in the alveolar bone during induced tooth movement, including alterations in the number of both osteoclasts and osteoblasts and in collagen deposition in both pressure and tension areas.

Tooth movement after infrared laser phototherapy: clinical study in rodents.

OBJECTIVES: The aim of this research was to investigate the influence of low-power laser on tooth movement in rats. BACKGROUND: Tooth movement is closely related to the process of bone remodeling. The biologic result, with the application of a force to the tooth, is bone absorption on the pressure side and neoformation on the traction side of the alveolar bone. The laser photobiomodulation is capable of providing an increase in cellular metabolism, blood flow, and lymphatic drainage. METHODS: Thirty young-adult male Wistar rats weighing between 250 and 300 g were divided into two groups, control and experimental, containing 15 animals each. The animals received orthodontic devices calibrated to release a force of 40 g/F, with the purpose of moving the first upper molar mesially. Low-intensity laser, wavelength 790 nm, was used in the experimental group; the dose was 4.5 J/cm(2) per point, mesial and distal, on the palatal side, 11 J/cm(2) on the buccal side, and this procedure was repeated every 48 h, totaling nine applications. The active movement was clinically evaluated after 7, 13, and 19 days. RESULTS AND CONCLUSION: The results showed no statistically significant difference, p = 0.079 (T0-T7), p = 0.597 (T7-T13), and p = 0.550 (T13-T19) between the laser and control groups on the amount of tooth movement in the different times evaluated. It may be concluded that laser phototherapy, with the parameters in the present study, did not significantly increase the amount of tooth displacement during induced orthodontic movement in rodents.

Vertical control in the Class III compensatory treatment

INTRODUCTION: Compensatory orthodontic treatment, or simply orthodontic camouflage, consists in an important alternative to orthognathic surgery in the resolution of skeletal discrepancies in adult patients. It is important to point that, to be successfully performed, diagnosis must be detailed, to evaluate, specifically, dental and facial features, as well as the limitations imposed by the magnitude of the discrepancy. The main complaint, patient's treatment expectation, periodontal limits, facial pattern and vertical control are some of the items to be explored in the determination of the viability of a compensatory treatment. Hyperdivergent patients who carry a Class III skeletal discrepancy, associated with a vertical facial pattern, with the presence or tendency to anterior open bite, deserve special attention. In these cases, an efficient strategy of vertical control must be planned and executed. OBJECTIVE: The present article aims at illustrating the evolution of efficient alternatives of vertical control in hiperdivergent patients, from the use, in the recent past, of extra-oral appliances on the lower dental arch (J-hook), until nowadays, with the advent of skeletal anchorage. But for patients with a more balanced facial pattern, the conventional mechanics with Class III intermaxillary elastics, associated to an accentuated curve of Spee in the upper arch and a reverse Curve of Spee in the lower arch, and vertical elastics in the anterior region, continues to be an excellent alternative, if there is extreme collaboration in using the elastics.

INTRODUÇÃO: o tratamento ortodôntico compensatório, ou simplesmente camuflagem ortodôntica, consiste em uma importante alternativa à cirurgia ortognática na resolução de discrepâncias esqueléticas em pacientes adultos. Torna-se importante salientar que, para ser instituído de maneira bem-sucedida, deve-se realizar detalhado diagnóstico, avaliando de maneira específica as características dentárias e faciais, assim como as limitações impostas pela magnitude da discrepância. A queixa principal, as expectativas do paciente frente ao tratamento, os limites periodontais, padrão facial e controle vertical são alguns dos itens a serem explorados na determinação da viabilidade de um eventual tratamento compensatório. Os pacientes portadores de discrepância esquelética de Classe III associada a padrão facial vertical, hiperdivergente, com a presença ou tendência à mordida aberta anterior, merecem uma atenção especial. Nesses casos, uma eficiente estratégia de controle vertical deve ser planejada e instituída. OBJETIVO: o presente artigo tem como objetivo ilustrar a evolução de alternativas eficientes para controle vertical em pacientes hiperdivergentes - desde a utilização, em um passado recente, de dispositivos extrabucais na arcada inferior (J-hook), indo até os dias atuais, com o advento da ancoragem esquelética. Já para pacientes com um padrão facial mais equilibrado, a mecânica convencional com elásticos intermaxilares na direção de Classe III, associada à curva de Spee acentuada na arcada superior, reversa na inferior e elásticos verticais na região anterior, continua sendo uma excelente alternativa, desde que haja extrema colaboração na utilização dos elásticos.