Oxidative stress and genotoxicity in oral epithelial cells from subjects undergoing orthodontic treatment with fixed appliances.

OBJECTIVES: The objective of this work was to evaluate the impact of fixed orthodontic appliances on oxidative stress (OS) and genotoxicity from oral epithelial cells. MATERIALS AND METHODS: Samples of oral epithelial cells were obtained from fifty-one healthy voluntary subjects who had an indication for orthodontic treatment. The samples were obtained before treatment and after 6 and 9 months of treatment. OS was evaluated by quantitating 8-hydroxy-2'deoxyguanosine (8-OHdG) and by performing relative gene expression with antioxidant enzymes superoxide dismutase (SOD) and catalase (CAT). DNA degradation and instability were evaluated by multiplex polymerase chain reaction (PCR) and fragment analysis for human identification. RESULTS: The quantitation results showed that 8-OHdG increased during treatment, although this increase was not statistically significant. SOD increased by 2.5- and 2.6-fold after 6 and 9 months of treatment, respectively. CAT increased by threefold after 6 months of treatment, while after 9 months of treatment, the expression level decreased to a level similar to that before treatment. DNA degradation was found in 8% and 12% of DNA samples after 6 and 9 months of treatment, respectively, while DNA instability was detected in only 2% and 8% of DNA samples after 6 and 9 months of treatment, respectively. CONCLUSIONS: The results showed that OS and genotoxicity slightly changed after treatment with a fixed orthodontic appliance; in addition, a biological adaptation response to the treatment may occur after 6 months. CLINICAL RELEVANCE: OS and genotoxicity in the buccal cavity are risk factors for oral and systemic diseases. This risk may be reduced through antioxidant supplementation, by using thermoplastic materials, or by reducing the orthodontic treatment time.

Photobiomodulation and Pain Reduction in Patients Requiring Orthodontic Band Application: Randomized Clinical Trial.

PURPOSE: The aim of this study was to investigate the effect of Photobiomodulation (PBM) in managing orthodontic pain intensity over time in patients requiring band application on upper first molars. METHODS: Maxillary first molars were banded. In the trial group, each molar received single-session PBM on two buccal and two palatal points (λ = 830 ± 10 nm; 150 mW, 7.5 J/cm2; spot of 0.1 cm2; 5 sec per point), while the control group received a placebo treatment. All patients were asked to answer five pain rating scales to assess pain intensity at 5 minutes and 1, 12, 24, and 72 hours and completed a survey describing the type of pain and its temporal course in the next 7 days. RESULTS: 26 patients (mean age 11.8 years) were randomly assigned to a control or a trial group. The trial group showed significantly lower pain intensities (p < 0.05) at 5 min (M = 0.92, SD = 1.32), 1 h (M = 0.77, SD = 1.01), and 12 h (M = 0.77, SD = 1.54) after band application compared to the control group (5 min: M = 1.62, SD = 1.26; 1 h: M = 1.77, SD = 1.92; and 12 h: M = 1.77, SD = 2.17), whereas no difference between groups (p > 0.05) was found at 24 h (trial: M = 0.62, SD = 1.71; control: M = 1.08, SD = 1.75) and 72 h (trial: M = 0.31, SD = 0.75; control: M = 0.15, SD = 0.55). Patients in the control group reported more frequently the presence of "compressive pain" (58.8%, p < 0.05) from the appliance during the week after the application, while the trial group showed higher frequency of "no pain" (46.2%, p < 0.05). However, PBM did not affect the pain onset (trial: M = 10.86, SD = 26.97; control: M = 5.25, SD = 7.86), peak (trial: M = 15.86, SD = 26.29; control: 6.17, SD = 7.96), and end time (trial: 39.57, SD = 31.33; control: M = 22.02, SD = 25.42) reported by the two groups (p > 0.05). CONCLUSIONS: PBM might be considered a promising alternative to decrease general pain intensity, although not affecting the typical pain cycle, in terms of the onset, peak, and ending times.

Evaluation of the use of photobiomodulation following the placement of elastomeric separators: Protocol for a randomized controlled clinical trial.

BACKGROUND: Pain stemming from the placement of elastomeric separators and the exchanging of wires and accessories is the greatest reason for abandoning orthodontic treatment. Indeed, discomfort related to treatment exerts a negative impact on quality of life due to the difficulty chewing and biting. This paper proposes a study to evaluate the analgesic effects of photomiobodulation (PBM) on individuals undergoing orthodontic treatment. METHODS: The sample will be composed of 72 individuals who receiving elastomeric separators on the mesial and distal faces of the maxillary first molars. The patients will be randomly allocated to 2 groups: an experimental group irradiated with low-level laser and a sham group submitted to simulated laser irradiation. Upon the placement of the separators, the experimental group will receive a single application of PBM on the mesial and distal cervical portion and apical third of the molars. Perceived pain will be analyzed after one hour using the visual analog scale in both groups. Samples will be taken of the gingival crevice with absorbent paper for 30 seconds for the analysis of cytokines using ELISA and the results of the 2 groups will be compared. The patients will sign a statement of informed consent. Statistical analysis will be performed with the Student's t test and analysis of variance (ANOVA). DISCUSSION: The expectation is that the patients in the irradiated group will have a lower perception of pain and lower quantity of cytokines compared to those in the sham group. The purpose of the study is to establish an effective method for PBM with the use of low-level infrared laser (Ga-Al-As with a wavelength of 808 nm and output power of 100 mW) for reductions in pain and inflammatory cytokines related to orthodontic treatment. TRIAL REGISTRATION: This protocol was registered in ClinicalTrial.gov, under number NCT03939988. It was first posted and last updated in May 6, 2019.

Ibuprofen and Low-level Laser Therapy for Pain Control during Fixed Orthodontic Therapy: A Systematic Review of Randomized Controlled Trials and Meta-analysis.

INTRODUCTION: To systematically review high-quality randomized controlled trials (RCTs) and meta-analysis on the effectiveness of use of ibuprofen and low-level laser therapy (LLLT) for pain control during fixed orthodontic appliance therapy. MATERIALS AND METHODS: A web-based systematic search of PubMed and Medline database using relevant keywords was performed in August 2016 limited to the English language studies. Based on inclusion and exclusion criteria, RCTs utilizing blind approach were selected. The quality of studies was analyzed and only high-quality studies were included. Following data extraction, meta-analysis was performed by standardized mean difference Hedges' (adjusted) g with 95% confidence interval. RESULTS: A total number of six studies (four ibuprofen and two LLLT) comprising 315 patients were included. Heterogeneity among ibuprofen studies was small, while large heterogeneity was found among LLLT studies. The results showed that both ibuprofen and LLLT could reduce pain intensity during fixed orthodontic therapy and during 17 days follow-up period. However, this reduction was statistically significant only at 6 to 24 hours postoperatively for ibuprofen and 2 hours and 3 to 7 days for LLLT (p < 0.05). CONCLUSION: Considering the limitations of the current meta-analysis, ibuprofen could alleviate orthodontic archwire activation pain during the 1st day with relatively high level of evidence. Low-level laser therapy could reduce this pain in the long term with limited evidence. Further well-designed RCTs are required to provide more evidence.

Do Dietary Habits Influence Trace Elements Release from Fixed Orthodontic Appliances?

The objective was to investigate the effect of dietary habits on the release of Cr and Ni ions from orthodontic appliances by hair mineral analysis. Patients (N = 47) underwent electronic questionnaire survey to investigate the effect of dietary habits on Cr and Ni levels in hair. The research was carried out on hair sampled at the beginning and in the 4th, 8th, and 12th months of the treatment. The content of Cr and Ni in the collected samples was determined by ICP-OES. The study showed that consumption of acidic dietary products may have the effect on increasing the release of Cr and Ni ions from orthodontic appliances. The release of Cr from orthodontic appliances in patients who consumed fruit juice, coffee, yoghurt, and vinegar was higher. The coefficients enabling comparison of metal ions release pattern at a given sampling points were defined. The comparison of the coefficients yielded the information on the possible magnification of metal ions released as the result of the additional factor consumption of acidic food or drink that intensifies metal ions release. The following magnification pattern was found for chromium: coffee (7.57 times) > yoghurt (2.53) > juice (1.86) > vinegar (1.08), and for nickel: vinegar (2.2) > coffee (1.22) > juice (1.05). Yoghurt did not intensify the release of nickel. Concluding, orthodontic patients should avoid drinking/eating coffee, yoghurt, fruit juices, and vinegar.

Correlation of Orthodontic Treatment by Fixed or Myofunctional Appliances and Periodontitis: A Retrospective Study.

INTRODUCTION: Malocclusion plays an important role in the development of periodontitis. Thus, by treating malocclusion, a good gingival health can be achieved. This study was conducted to establish the correlation between orthodontic tooth movement and periodontitis. MATERIALS AND METHODS: This is a retrospective study conducted on 220 patients who underwent orthodontic treatment for malocclusion. They were divided into two groups: Group I patients were treated with fixed orthodontics, while group II patients received myofunctional appliances. RESULTS: The value for plaque, gingival recession, and tooth mobility significantly increased in group I patients. However, the difference was statistically nonsignificant in group II patients. CONCLUSION: The authors concluded that there is correlation between malocclusion and periodontitis. Malocclusion leads to periodontitis. CLINICAL SIGNIFICANCE: Malocclusion is the main reason for the development of poor periodontal health. Combined effort has to be played by both periodontist and orthodontist for the treatment of various orthodontic-periodontal problems.

Three consecutive days of application of LED therapy is necessary to inhibit experimentally induced root resorption in rats: a microtomographic study.

Previous studies have suggested that phototherapy may modulate orthodontic tooth movement and the incidence of root resorption. We aimed to identify a minimal dose-response relationship to LED therapy with regard to orthodontic tooth movement (OTM) and root resorption in rats. Forty-eight male Wistar rats were divided into six groups with equal and random distribution: control (C) no intervention; three daily LED irradiation (CLED); submitted only to OTM (RR); OTM and LED irradiation on the first day (LED1); OTM and two LED irradiation on the first and second days (LED2); and OTM and three LED irradiation on the first, second, and third days (LED3). Orthodontic appliance was installed in groups RR, LED1, LED2, and LED3 to promote OTM. Animals from groups CLED, LED1, LED2, and LED3 received LED therapy (940 nm, 4 J, 4 J/cm2) according to each group of treatment. After 7 days, all the animals were sacrificed. The jaws were fixed and scanned with microtomography (micro-CT). The micro-CT images were reconstructed on 2D and 3D models. These models were used to identify and measure root resorption number and dimensions (diameter, depth, and volume). The distance between the first and second molars was used to verify tooth displacement. The results showed that LED3 group had significantly lower number of root resorption. The root resorption dimensions (diameter and depth) had no significant differences among the experimental groups. LED3 group had significant tooth displacement in relation to C and CLED groups. In conclusion, three daily LED therapy doses are required to inhibit root resorption after appliance of orthodontic forces.

Prevention and treatment of white spot lesions during and after fixed orthodontic treatment: A systematic literature review.

OBJECTIVE: The aim of the study is to evaluate the effectiveness of fluoride and casein topical preparations in the prevention of white spot lesions during and after fixed orthodontic treatment. MATERIAL AND METHODS: Information search for controlled studies on humans published in the English language between 2008 and 2013 was conducted in Medline via PubMed, ScienceDirect, and Oxford University Press: Oxford journals and The Cochrane Library, as well as the Web search Google Scholar. 177 articles were reviewed; eleven clinical studies fulfilled all inclusion criteria. RESULTS: In the clinical studies it was concluded that high-concentration fluoride supplements are effective in reducing white spot lesions. Results of the studies showed the same usefulness of fluoride varnish, MI Paste, and usual oral hygiene using 1100 ppm of fluoride toothpaste. Effect on the prevention and treatment of white spot lesions of oral hygiene with toothpaste containing 1450 ppm of fluoride in orthodontic patients was evaluated. The positive effect of casein phosphopeptide-amorphous calcium phosphate in white spot lesions treatment was found. Otherwise in some clinical studies use of casein derivates during fixed orthodontics for white spot lesions treatment was not effective. CONCLUSIONS: More clinical studies conducted during last five years yielded significantly positive results about the effectiveness of fluoride and caseine supplements in ameliorating white spot lesions during and after fixed orthodontic treatment. For a higher-risk patient group, additional supplements such as high-concentrated fluoride varnish, chewing sticks, or casein derivates, are required. A good oral hygiene regimen using high-fluoride toothpaste is as effective as fluoride or casein derivates in the prevention of new white spot lesions formation.

Pain reduced by low-level laser therapy during use of orthodontic separators in early mixed dentition.

OBJECTIVE: The purpose of this work was to investigate whether low-level laser therapy (LLLT) applied at a defined distance from the gingiva has a pain-reducing effect in young patients undergoing orthodontic separation during the early mixed-dentition stage. MATERIALS AND METHODS: A total of 40 children in early mixed dentition (mean age 8.05 years) who required separation of molars were included. The study comprised a group of 20 patients whose treatment included laser application on the day of separation and a control group of 20 patients not receiving LLLT. All patients recorded their maximum pain intensities on the day of separation (day 1) and on the following 4 days. RESULTS: Compared to the control group, pain perception was significantly reduced (p < 0.05) in the LLLT group on day 1 and continued to be reduced on day 2. Equivalent pain levels were recorded in both groups on days 3-5. CONCLUSION: Given our findings of a pain-reducing effect in young patients undergoing orthodontic separation during the early mixed-dentition stage, LLLT is an interesting alternative option of providing analgesia even in very young patients.

Orthodontic post-adjustment pain control with acupuncture.

OBJECTIVE: This study aimed to evaluate the analgesic efficacy of systemic acupuncture therapy on the pain caused after orthodontic adjustments. METHODS: An initial sample of 30 orthodontic patients with fixed appliances monthly adjusted was selected; however, only 11 participants completed the study. For this reason, final sample comprised these patients' data only. Initially, average pain levels were assessed at different periods by means of an analogue visual scale (VAS) for three months without acupuncture. In the following three months, the volunteers were submitted to systemic acupuncture sessions on Hegu (LI4) and Jiache (St6) points, before orthodontic adjustments were carried out. RESULTS: Results revealed statistically significant reduction in pain level indexes both for men (P = 0.030) and women (P = 0.028) when acupuncture therapy was performed prior to orthodontic adjustment. Patients did not present any side effects. CONCLUSION: Acupuncture is a safe and effective method in reducing orthodontic post-adjustment pain.

Orthodontic post-adjustment pain control with acupuncture

OBJECTIVE: This study aimed to evaluate the analgesic efficacy of systemic acupuncture therapy on the pain caused after orthodontic adjustments. METHODS: An initial sample of 30 orthodontic patients with fixed appliances monthly adjusted was selected; however, only 11 participants completed the study. For this reason, final sample comprised these patients' data only. Initially, average pain levels were assessed at different periods by means of an analogue visual scale (VAS) for three months without acupuncture. In the following three months, the volunteers were submitted to systemic acupuncture sessions on Hegu (LI4) and Jiache (St6) points,before orthodontic adjustments were carried out. RESULTS: Results revealed statistically significant reduction in pain level indexes both for men (P = 0.030) and women (P = 0.028) when acupuncture therapy was performed prior to orthodontic adjustment. Patients did not present any side effects. CONCLUSION: Acupuncture is a safe and effective method in reducing orthodontic post-adjustment pain. .

OBJETIVO: o presente trabalho objetivou avaliar a eficácia analgésica da acupuntura sistêmica, realizada previamente, sob a dor oriunda pós-ajuste ortodôntico. MÉTODOS: uma amostra de 30 indivíduos usuários de aparelhos fixos foi selecionada, os quais tinham de ser ajustados mensalmente. Contudo, somente 11 participantes completaram o estudo, e somente os seus dados foram coletados e analisados. A princípio, foi realizada uma média do índice de dor, em diferentes períodos, por meio de uma escala analógica visual (EAV), por três meses, sem a utilização da acupuntura. Nos três meses seguintes, os voluntários foram submetidos a sessões de acupuntura sistêmica nos pontos Hegu (IG4) e Jiache (E6), previamente ao ajuste ortodôntico. A média dos resultados do índice de dor com e sem acupuntura foram comparados. RESULTADOS: os resultados demonstraram que houve redução estatisticamente significativa no índice geral de dor, tanto para os homens (p = 0,030) quanto para as mulheres (p = 0,028), após a utilização da acupuntura previamente ao ajuste, e nenhum voluntário apresentou efeitos adversos. CONCLUSÃO: conclui-se que os pontos de acupuntura utilizados são eficientes e seguros na redução da dor pós-ajuste ortodôntico. .

The effect of 810-nm low-level laser therapy on pain caused by orthodontic elastomeric separators.

The purpose of this study was to assess the effect of 810-nm (DMC Equipamentos, Sao Carlos, Brazil) continuous wave low-level laser therapy (LLLT) on the pain caused by orthodontic elastomeric separators. Thirty-seven orthodontic patients (12 male and 25 female, aged 11-32 years, mean age = 24.97 years) participated in the study, including 20 subjects aged 18 years or more, and 17 under 18 years of age. Four elastomeric separators (Dentarum, Springen, Germany) were placed for the first permanent molars (distal and mesial), either for maxillary (22 patients) or mandibular (15 patients) arches; one quadrant was randomly selected and used as a placebo group (received no laser irradiation). After separator placement for each quadrant, patients received 10 doses (2 J/cm(2), 100 mW, 20 s) of laser irradiation on the buccal side (at the cervical third of the roots), for distal and mesial of the second premolars and first permanent molars, as well as distal of second permanent molars (five doses). The same procedure was repeated for the lingual or palatal side (five doses). After 24 h, patients returned to the clinic and received another 10 doses of laser irradiation on the same quadrant. Postseparation pain level recorded on a 10-cm visual analog scale for both jaws immediately (hour 0), and after 6, 24, 30 h, as well as on days 3, 4, 5, 6, and 7. Significant differences in the pain perception (PP) were found between the laser and placebo groups at 6, 24, 30 h, and day 3 of the experiment (P < 0.05). Friedman's test of multiple comparisons revealed significant differences in the PP among various time intervals for laser (chi-square = 173.407, P = 0.000) and placebo (chi-square = 184.712, P = 0.000) groups. In both groups, pain was highest at 6 and 30 h after placing elastomeric separators. No gender differences were observed in both groups. More pain was recorded in the mandible (P < 0.05) at 24 (laser group) and 30 h (both groups) after starting the experiment. The PP was significantly higher (P < 0.05) for the group aged 18 years or more, only at days 3 [both groups] and 4 [laser group only] of the experiment. The 810-nm continuous wave LLLT significantly reduced the PP in the first 3 days after orthodontic separation. However, the mean postseparation PP in both groups was low and wide ranges of PP scores were observed.

Protective effects of Ginkgo biloba extract on ligature-induced periodontitis in rats.

OBJECTIVE: The aim of this study was to test the hypothesis that the systemic administration of extract of Ginkgo biloba (EGb) would prevent excessive tissue destruction in ligature-induced periodontitis in a rat model. MATERIALS AND METHODS: Thirty-two male Wistar albino rats were used in the current study. The rats were randomly divided into four groups of eight rats each: (1) non-ligated treatment (NL) group, (2) ligature-only (LO) group, (3) ligature plus GB28 (28 mg/kg, daily for 11 days) group and (4) ligature plus GB56 (56 mg/kg, daily for 11 days) group. RESULTS: Measurement of alveolar bone loss in the mandibular molar tooth revealed significantly lower bone loss values in the LO group compared to groups NL, GB28 and GB56 (p < 0.05). CONCLUSION: The present results are the first data which suggests that host response in periodontitis can be modified by EGb administration. EGb minimized progression of periodontal disease.

Effect of frequent laser irradiation on orthodontic pain. A single-blind randomized clinical trial.

OBJECTIVE: To analyze the effect of low-level laser therapy (LLLT) on perception of pain after separator placement and compare it with perceptions of control and placebo groups using a frequent irradiation protocol. MATERIALS AND METHODS: Eighty-eight patients were randomly allocated to a laser group, a light-emitting diode (LED) placebo group, or a control group. Elastomeric separators were placed on the first molars. In the laser and LED groups, first molars were irradiated for 30 seconds every 12 hours for 1 week using a portable device. Pain was marked on a visual analog scale at predetermined intervals. Repeated measure analysis of variance was performed for statistical analysis. RESULTS: The pain scores of the laser group were significantly lower than those of the control group up to 1 day. The pain scores in the LED group were not significantly different from those of the laser group during the first 6 hours. After that point, the pain scores of the LED group were not significantly different from those of the control. CONCLUSIONS: Frequent LLLT decreased the perception of pain to a nonsignificant level throughout the week after separator placement, compared with pain perception in the placebo and control groups. Therefore, LLLT might be an effective method of reducing orthodontic pain.

Low-level laser therapy for treatment of pain associated with orthodontic elastomeric separator placement: a placebo-controlled randomized double-blind clinical trial.

OBJECTIVE: The objective of this study was to evaluate the effectiveness of the use of irradiation with a low-level laser therapy (LLLT), wavelength 830 nm, for treating pain inherent to tooth movement caused by orthodontic devices, simulated by positioning interdental elastomeric separators. METHODS: Sixty orthodontic patients were randomly assigned to two groups: GA (ages 12-25 years; mean 17.1 years) was the control, and GB (ages 12-26 years; mean 17.9 years) the intervention group. All patients received elastomeric separators on the mesial and distal surfaces of one of the lower first molars, and immediately after insertion of the separators received irradiation as randomly indicated. The intervention group (GB) received irradiation with LLLT (aluminum gallium arsenide diode), by a single spot in the region of the radicular apex at a dose of 2 J/cm(2) and application along the radicular axis of the buccal surface with three spots of 1 J/cm(2) (wavelength 830 nm; infrared). Control group (GA) received irradiation with a placebo light in the same way. This was a double-blind study. All the patients received a questionnaire to be filled out at home describing their levels of pain 2, 6, and 24 h and 3 and 5 days after orthodontic separator placement, in situations of relaxed and occluded mouth. RESULTS: The patients in the intervention group (LLLT) had lower mean pain scores in all the measures. The incidence of complete absence of pain (score=0) was significantly higher the intervention group. CONCLUSIONS: Based on this study, authors concluded that single irradiation with LLLT of wavelength 830 nm efficiently controlled the pain originating from positioning interdental elastomeric separators, to reproduce the painful sensation experienced by patients when fixed orthodontic devices are used.

Evidências preliminares da eficácia de um gel contendo 5% de própolis para o controle da alteração gengival observada em pacientes portadores de aparelho ortodôntico fixo / Preliminary evidence of effectiveness of a gel containing 5% propolis for the control of gingival changes seen in patients with fixed orthodontic appliances

O aumento de volume gengival constitui um grupo grande de alterações, tanto do componente celular, quanto do tecido fibroso periodontal. A etiologia do aumento do volume gengival é diversa e varia desde processos inflamatórios agudos ou crônicos causados por fatores irritativos locais, doenças sistêmicas atuantes, fatores hereditários, anatômicos ou como efeito colateral de terapêuticas medicamentosas. O aumento gengival generalizado é comumente causado por resposta inflamatória à placa bacteriana, muito comum em pacientes ortodônticos. Agentes químicos bucais à base de extratos de plantas medicinais e própolis existem à venda no mercado brasileiro sem, contudo, terem passado por estudos clínicos cientificamente comprovados quanto à sua eficácia e quanto a possíveis efeitos indesejáveis que possam alterar tecidos duros e moles da cavidade bucal. O objetivo deste estudo foi obter evidências preliminares de um gel bucal contendo 5% de própolis verde (GBPV 5%) no controle das alterações no volume gengival e gengivite em pacientes portadores de aparelho ortodôntico fixo, durante 30 dias. A amostra foi constituída de 30 pacientes da Clínica de Especialização em Ortodontia da Faculdade de Odontologia da Universidade Federal de Minas Gerais, em Belo Horizonte, no período de março a outubro de 2013. Os pacientes foram submetidos à profilaxia completa das estruturas dentais antes de iniciarem o uso do gel. Foram instruídos a usar o gel 2 vezes ao dia, após as escovações (manhã e noite). Os participantes retornaram após 30 dias de utilização do produto para avaliação clínica. Nos T0 e T30 os pacientes foram avaliados considerando a presença de alterações nos tecidos moles e duros, coleta do índice gengival e fotografia dos primeiros prés-molares ­ mensuração da área da coroa clínica. Na última consulta (T30), os pacientes responderam a um questionário para avaliar o nível de apreciação e aceitabilidade deles em relação ao gel. Também será avaliada a aderência ao tratamento por meio de um formulário de frequência. Após a conclusão da pesquisa pode-se comprovar a eficácia gel de própolis na redução estatisticamente significante do índice de sangramento gengival e índice de gravidade gengival na população estudada. Houve um aumento relevante da coroa clínica porém não estatisticamente significante. O projeto foi submetido a avaliação do Comitê de Ética em Pesquisa da UFMG aprovado com o número 04346212.0.0000.5149, parecer da Plataforma Brasil 245.559

The volume increase of gingival constitutes a large group of changes to both the cellular component , the fibrous periodontal tissue . The etiology of the increase in gingival volume is diverse and ranges from acute or chronic inflammatory processes caused by local irritating factors , active systemic diseases, hereditary factors, anatomical or as a side effect of drug therapies . Increased gingival hyperplasia is commonly caused by the inflammatory response to plaque , very common in orthodontic patients . Chemical -based oral herbal extracts and propolis has been sold in the Brazilian market , but without having gone through clinical studies scientifically proven for their effectiveness and for possible side effects that may modify hard and soft tissues of the oral cavity . The goal of this study is obtain preliminary evidence of an oral gel containing 5% propolis (GBPV 5%) in control of changes in gingival volume and gingivitis in patients with fixed orthodontic appliances , over a period of 30 days. The sample consisted of 30 patients from the Clinic Specialist in Orthodontics, of the School of Dentistry of the Federal University of Minas Gerais in Belo Horizonte, from March to October 2013. The patients were submitted to a complete prophylaxis of dental structures before initiating the gel use. They were instructed to use the gel two times a day after brushing (morning and evening). The participants returned after 30 days of using the product for clinical evaluation. This research can prove the efficacy of propolis gel in a statistically significant reduction of gingival bleeding index and gingival index of severity in this population. There clinical crown had a large increase but not statistically significant. In T0 and T30 patients were evaluated considering the presence of changes in hard and soft tissue, gingival index and collection of the first photograph pres - molars - measuring the area of the clinical crown. The project was submitted to the Ethics in Research Committee of UFMG assent. Approval number 04346212.0.0000.5149. Plataforma Brasil approval number 245.559.

Immediate effects of the suboccipital muscle inhibition technique in craniocervical posture and greater occipital nerve mechanosensitivity in subjects with a history of orthodontia use: a randomized trial.

OBJECTIVE: The purpose of this study was to measure the immediate differences in craniocervical posture and pressure pain threshold of the greater occipital (GO) nerve in asymptomatic subjects with a history of having used orthodontics, after intervention by a suboccipital muscle inhibition (SMI) technique. METHODS: This was a randomized, single-blind, clinical study with a sample of 24 subjects (21±1.78 years) that were divided into an experimental group (n=12) who underwent the SMI technique and a sham group (n=12) who underwent a sham (placebo) intervention. The sitting and standing craniovertebral angle and the pressure pain threshold of the GO nerve in both hemispheres were measured. RESULTS: The between-group comparison of the sample indicated that individuals subjected to the SMI technique showed a statistically significant increase in the craniovertebral angle in both the sitting (P<.001, F1,22=102.09, R2=0.82) and the standing (P<.001, F1,22=21.42, R2=0.56) positions and in the GO nerve pressure pain threshold in the nondominant hemisphere (P=.014, F1,22=7.06, R2=0.24). There were no statistically significant differences observed for the GO nerve mechanosensitivity in the dominant side (P=.202). CONCLUSION: Suboccipital muscle inhibition technique immediately improved the position of the head with the subject seated and standing, the clinical effect size being large in the former case. It also immediately decreased the mechanosensitivity of the GO nerve in the nondominant hemisphere, although the effect size was small.

Uso del láser terapéutico en el control del dolor en ortodoncia / Use of laser therapy in pain control in orthodontics

Objetivo: Determinar si el láser de baja frecuencia (LLLT) es efectivo en disminuir la percepción del dolor posterior a la aplicación de separaciones molares para ortodoncia. Material y Método: Se realizó un ensayo clínico aleatorizado con enmascaramiento simple en 30 alumnos entre 16 y 20 años, a quienes se les aplicó separaciones elásticas entre los molares permanentes. Los voluntarios fueron designados en dos grupos: 15 pacientes en el grupo experimental quienes fueron tratados con LLLT (Photon Lase, DMC USA Corp.) por 30 segundos en cada molar permanente derecho y 15 pacientes en el grupo control quienes recibieron como placebo la colocación del láser inactivo con el mismo protocolo empleado en el grupo experimental. En total 30 dientes fueron incluidos en cada grupo. La percepción del dolor fue evaluada a las 3, 12, 24 horas y a los días 2, 3, 4, 5 y 7 posterior a la aplicación de LLLT a través de un cuestionario estándar de autollenado haciendo uso de la escala visual análoga del dolor (EVA). Resultados: El 61.6 por ciento de los pacientes del grupo de control presentó algún grado de dolor durante el periodo de seguimiento en comparación del 38.64 por ciento del grupo experimental (p=0.004). Si bien la intensidad del dolor alcanzó su punto máximo a las 12 horas las diferencias de los promedios entre ambos grupos también fue estadísticamente significativa (<0.001). Conclusión: El LLLT demostró ser una herramienta útil en el control del dolor posterior a la aplicación de separaciones molares.

Objective: To determine the effectiveness of low-level laser therapy (LLLT) to decrease the perception of pain after application of orthodontic molar separations. Material and Methods: We performed a randomized single-blind in 30 students between 16 and 20 years who were administered elastic separation between the permanent molars. Volunteers were assigned into two groups: 15 patients in the experimental group who were treated with LLLT (Photon Lase, DMC USA Corp.) for 30 seconds on each permanent right molar and 15 patients in the control group who received placebo-like placement inactive laser with the same protocol used in the experimental group. Altogether 30 teeth were included in each group. Pain perception was assessed at 3, 12, 24 hours and 2, 3, 4, 5 and 7 after application of LLLT through a standard questionnaire using the visual analogue scale of pain (EVA). Results: 61.6 percent of patients in the control group had some degree of pain during the follow-up period in comparison with the 38.64 percent of the experimental group (p =0.004). Although pain intensity peaked at 12 hours the mean differences between groups was statistically significant (<0.001). Conclusion: LLLT proved to be a useful tool in controlling pain after the application of separation molars.

Accidental ingestion of a fractured Twin-block appliance.

Orthodontic appliances that become dislodged can cause problems in the airway or the gastrointestinal tract. Accidental ingestion of an appliance during a chair-side procedure or because of inadequate retention of the appliance can create a medical emergency with potentially serious complications, including death from aspiration of the foreign body. This article reports the accidental ingestion of a fractured Twin-block appliance. The ease with which removable appliances can become dislodged if retention is inadequate is discussed, and some serious complications that can arise are described. Precautions the orthodontist can take to prevent such accidents are presented.