Pulse oximetry as a dental pulp test: A scoping review to identify barriers hindering the use of oximeters in clinical practice.

Background and Objective: Although medical pulse oximeters are considered effective for endodontic diagnoses, the method remains uncommon in current dental practice. The aim of the present scoping review was to investigate clinical factors that exert a negative impact on the use of pulse oximeters in dental practice. Methods: This study followed the PRISMA-ScR guidelines and the protocol was prospectively registered in the Open Science Framework (https://doi.org/10.17605/OSF.IO/3GQCE). A comprehensive search of the MEDLINE (via PubMed), Cochrane Library, and Web of Science databases was performed in December 2022 for articles published in English or Spanish. All types of clinical studies were included, except comments, letters to the editor, and abstracts. Two independent investigators analyzed 45 full-text articles. Data extraction included general characteristics, oxygen saturation levels, and limiting factors/barriers to the use of oximeters as pulp testers. Results: The search of the databases yielded 1,300 records and 38 were included (quantitative data extraction was performed for 35 and three articles were systematic reviews). Publications were highest in number between 2016 and 2017, with an evident reduction occurring after 2021. The oxygen saturation level for sound/vital maxillary anterior teeth was 84.99% (overall mean). The main limiting factors/barriers were i) the difficulty in maintaining the two light-emitting diodes parallel during pulp tests, ii) infrared light diffraction by enamel/dentin/gingiva, and iii) the diversity of patient ages in studies. Conclusion: This scoping review encountered noteworthy findings associated with the impracticability of using medical pulse oximeters as dental pulp testers. The recent decrease in the frequency of published studies compared to approximately seven years ago may imply a negative trend in the use of the method.

Effect of Radiotherapy and Low-Level Laser Therapy on Circulating Blood Cells of Rats.

Introduction: This study aimed to investigate the effect of low-level laser therapy (LLLT) on the blood cell count when applied to parotid glands of rats irradiated by volumetric modular arc therapy (VMAT). Methods: Thirty-two adult male Wistar rats were used in this study. Samples were randomly assigned to three groups: control group (CG, n = 8), immediate laser group (24 hours) (ILG, n=12), and late laser group (120 hours) (LLG, n=12). The two laser groups were previously subjected to VMAT radiotherapy in a single dose of 12 Gy. LLLT with an AsGaAl laser (660 nm, 100 mW) was applied at three points in the region of the parotid glands, right side, with the energy of 2 J per point (20s, 70 J/cm2) and a spot size of 0.0028 cm2 for 10 consecutive days. In the euthanasia, blood samples were obtained by cardiac puncture. The samples from each group were processed by an automatic method and analyzed for erythrogram, leukogram and platelet count values. The data were analyzed by ANOVA and each LLLT time point was analyzed in relation to the control group, with a significance level less than 0.05. Results: Groups using LLLT had higher red blood cell counts, being higher in the LLG (P = 0.000). The hematimetric indices MCV (P = 0.002) and MCH (P = 0.009) were lower than the control group, especially when compared to the group using LLLT 120h after radiotherapy (LLG). White blood cell counts were lower in the groups with radiotherapy and immediate use of LLLT (ILG) (P = 0.011), mainly at the expense of lymphocytes (P = 0.002). Conclusion: The results suggest a potential systemic effect of LLLT, especially on circulating red blood cell counts, regardless of their time of immediate or late use of radiotherapy.

Evaluation of effect of a vitamin-based barrier cream on the clinical severity of actinic cheilitis: A preliminary study.

BACKGROUND: Actinic Cheilitis (AC) is a pathological condition of the labial mucosa considered potentially malignant. The aim of this study was to investigate the effect of treatment of AC with daily use of a vitamin-based barrier cream. MATERIAL AND METHODS: For this clinical study, 36 participants with lower-lip AC were recruited from three oral medicine services. At baseline, participants were evaluated by clinical examination and clinical severity of AC was classified as grade I to IV. All participants were dispensed a tube of a barrier cream containing vitamins A, D, E and ZnO to apply once nightly for 90 consecutive days. Monthly follow-up was performed to reclassify AC clinial severity. The primary outcome of interest was clinical remission of AC at 90-day follow-up compared to baseline. RESULTS: Progressive remission of AC lesions was observed as early as the first month and throughout the assessment period (p = 0.000). The 3-month period was insufficient for remission of lesions, especially among male participants (p = 0.002) and with a longer sun exposure in years (p = 0.007). CONCLUSIONS: Daily use of the vitamin-based barrier cream had a promissing positive impact on the severity of actinic cheilitis. However, a 90-day course of treatment was not sufficient to achieve lesions remission. The findings of this study suggest a promising new avenue for the treatment of lower-lip AC. Key words:Actinic cheilitis, vitamins, retinoids, vitamin D, therapeutics.

Evaluation of Aquaporins 1 and 5 Expression in Rat Parotid Glands After Volumetric Modulated Arc Radiotherapy and Use of Low-Level Laser Therapy at Different Times.

Introduction: This experimental study investigated the mRNA expression of aquaporins (AQPs) 1 and 5 in the parotid glands of rats irradiated with volumetric modulated arc therapy (VMAT) and subjected to low-level laser therapy (LLLT) at different time points. Methods: The sample consisted of 30 Wistar rats (Rattus norvegicus) divided into the following groups: control, LLLT alone (LG), radiotherapy alone (RG), and experimental groups that received LLLT at 24 hours (early experimental group [EEG], n=12) and 120 hours (late experimental group [LEG], n=12) after radiotherapy. VMAT was delivered at a single dose (12 Gy) and LLLT was performed with an aluminium-gallium-arsenide diode laser (660 nm, 100 mW), spot area of 0.0028 cm2, energy of 2 J/cm2 applied to 3 spots in the region corresponding to the right parotid gland, for 10 consecutive days. The right parotid gland was resected and prepared for RNA extraction. The gene expression of AQPs was evaluated by quantitative polymerase chain reaction (qPCR) using specific TaqMan probes, with the HPRT gene as an internal control. Results: The lowest AQP1 gene expression was 0.83 (0.27) with the use of LLLT 24 hours after radiotherapy (EEG), and the highest was 1.56 (0.80) with the use of LLLT alone (LG). Likewise, the lowest AQP5 gene expression was found in the EEG (mean = 0.88; SD = 0.49) and the highest in the LG (mean = 1.29; SD = 0.33). Conclusion: The use of LLLT after radiotherapy may contribute to the maintenance and an increase of these proteins, even when used at a later time point after radiotherapy.

A Retrospective Study of Oral and Maxillofacial Injuries in an Emergency Hospital in Southern Brazil

Objective: To identify and analyze cases of OMF treated in an emergency hospital in southern Brazil. Material and Methods: The investigators conducted a retrospective, cross-sectional study. The sample was composed of 1,533 patient medical records. Demographic, seasonal, and clinical variables were collected. Additionally, the medical records also included data on etiological factors, injury site, and tissues involved. A descriptive analysis was conducted based on 1,179 (76.9%) records of OMF injuries. Results: Most patients were male children and adolescents. Accidents (59.7%), such as falls, and interpersonal violence (18.7%), such as physical aggression, were the main etiological factors. Most injuries involved soft tissue (66.4%), especially in the lip region; whereas fractures affected the nasal bones. Transfers and hospitalizations accounted for 8.1% of clinical outcomes and dentists participated in the treatment of 85% of cases. Conclusion: The results of this study suggest a higher prevalence of OMF injuries in men, affecting young people more frequently and showing falls as the main etiological factor. Dentists participated in the majority of the medical care. Future studies will focus on determining risk groups, developing preventive programs, and improving health care services, with the participation of dentists in the multidisciplinary team.

Tratamento da queilite actínica através da técnica cirúrgica da vermelhectomia / Treatment of actinic cheilitis by surgical vermilionectomy

A queilite actínica é uma lesão cancerizável que acomete principalmente o lábio inferior, cujo fator etiológico está relacionado à exposição crônica aos raios ultravioletas. Possui uma predileção aumentada por indivíduos que apresentam atividade laboral com intensa exposição ao sol. Clinicamente, observam-se áreas maculares brancas ou avermelhadas ou lesões em forma de placas esbranquiçadas resultantes da hiperceratinização do epitélio do lábio, a qual pode progredir para a perda do limite entre a pele, vermelhão do lábio e a mucosa. Essas lesões são geralmente assintomáticas e podem progredir para áreas erosivas e/ou ulceradas. Dentre as diversas formas de tratamento, há a vermelhectomia, que consiste num procedimento cirúrgico para a remoção parcial ou total do vermelhão do lábio, apresentando baixo custo e permitindo a disponibilidade de material para exame anatomopatológico. O objetivo desse trabalho é relatar a técnica de vermelhectomia no tratamento de um paciente com diagnóstico de queilite actínica...

Actinic cheilitis is a potentially premalignant condition that is primarily found on the lower lip. Etiology is related to chronic exposure to ultraviolet light and the condition exhibits a strong predilection for people whose work involves intense exposure to the sun. Clinically observable signs include white or reddened areas of maculation or whitish plaques caused by hyperkeratinization of the lip epithelium, which can progress to a point at which the demarcation between the skin, vermillion border of the lip and the mucosa is lost. These lesions are generally asymptomatic but may progress to form areas of erosion and/or ulceration. There are a number of treatments available, one of which, vermilionectomy, is a surgical procedure in which the vermillion border of the lip is partially or totally removed and which, in addition to being inexpensive, offers the advantage of providing material for pathological analysis. The objective of this study is to describe the vermilionectomy technique as used to treat a patient diagnosed with actinic cheilitis...