Buffered 2% articaine in buccal infiltration of mandibular molars: a randomized triple-blind clinical trial.

This crossover study aimed to compare the anesthetic effects of buffered 2% articaine with 1:200,000 epinephrine with that of non-buffered 4% articaine with 1:200,000 epinephrine. Forty-seven volunteers were administered two doses of anesthesia in the buccal region of the second mandibular molars in two sessions using 1.8 mL of different local anesthetic solutions. The onset time and duration of pulp anesthesia, soft tissue pressure pain threshold, and the score of pain on puncture and burning during injection were evaluated. The operator, volunteers, and statistician were blinded. There were no significant differences in the parameters: onset of soft tissue anesthesia (p = 0.80), duration of soft tissue anesthesia (p = 0.10), onset of pulpal anesthesia in the second (p = 0.28) and first molars (p = 0.45), duration of pulp anesthesia of the second (p = 0.60) and first molars (p = 0.30), pain during puncture (p = 0.82) and injection (p = 0.80). No significant adverse events were observed. Buffered 2% articaine with 1:200,000 epinephrine did not differ from non-buffered 4% articaine with 1:200,000 epinephrine considering anesthetic success, safety, onset, duration of anesthesia, and pain on injection.

Promising potential of articaine-loaded poly(epsilon-caprolactone) nanocapules for intraoral topical anesthesia.

To determine whether the permeation capacity and analgesic efficacy of articaine (ATC) could be increased and cytotoxicity decreased by encapsulation in poly(ɛ-caprolactone) nanocapsules (ATCnano), aiming at local or topical anesthesia in dentistry. Cellular viability was evaluated (using the MTT test and fluorescence microscopy) after 1 h and 24 h exposure of HaCaT cells to ATC, ATCnano, ATC with epinephrine (ATCepi), and ATC in nanocapsules with epinephrine (ATCnanoepi). The profiles of permeation of 2% ATC and 2% ATCnano across swine esophageal epithelium were determined using Franz-type vertical diffusion cells. Analgesic efficacy was evaluated with a von Frey anesthesiometer in a postoperative pain model in rats, comparing the 2% ATC, 2% ATCnano, 2% ATCepi, and 2% ATCnanoepi formulations to 4% ATCepi (a commercially available formulation). We show that use of the nanocapsules decreased the toxicity of articaine (P<0.0001) and increased its flux (P = 0.0007). The 2% ATCepi and 4% ATCepi formulations provided higher analgesia success and duration (P<0.05), compared to 2% ATC, 2% ATCnano, and 2% ATCnanoepi. Articaine-loaded poly(ɛ-caprolactone) nanocapsules constitute a promising formulation for intraoral topical anesthesia (prior to local anesthetic injection), although it is not effective when injected in inflamed tissues for pain control, such as irreversible pulpitis.

Herbal medicines as anxiolytics prior to third molar surgical extraction. A randomized controlled clinical trial.

OBJECTIVES: This study aimed to compare the effects of Passiflora incarnata, Erythrina mulungu, and midazolam in controlling anxiety in patients undergoing mandibular third molar extraction. METHODS: The volunteers underwent extraction of their third mandibular molars in a randomized, placebo-controlled, triple-blind, and parallel clinical trial. Passiflora incarnata (500 mg), Erythrina mulungu (500 mg), or midazolam (15 mg) was orally administered 60 min before the surgery. The anxiety level of participants was evaluated using questionnaires and measurements of physical parameters, including heart rate (HR), blood pressure (BP), and oxygen saturation (SpO2). RESULTS: A total of 200 volunteers were included in this clinical trial. Considering each procedure independently, no significant differences (p > 0.05) in BP, HR, and SpO2 were observed among the protocols. CONCLUSIONS: Passiflora incarnata showed a similar effect to midazolam but differed from placebo and mulungu, which were unable to control anxiety in this situation. Therefore, the results suggest that Passiflora configures an herbal medicine with an anxiolytic effect, adequate to use in third molar extractions. CLINICAL RELEVANCE: The use of Passiflora incarnata may be an alternative to benzodiazepines for controlling anxiety in patients scheduled for oral surgery under local anesthesia. TRIAL REGISTRATION: ClinicalTrials.gov : ANSI-388.427.

Can local anesthesia with ropivacaine provide postoperative analgesia in extraction of impacted mandibular third molars? A randomized clinical trial.

OBJECTIVE: The aim of this study was to compare the local anesthesia efficacy of ropivacaine 0.75% compared to lidocaine 2% with 1:100,000 epinephrine for postoperative analgesia following extraction of impacted mandibular third molars. STUDY DESIGN: In this randomized, double-blind crossover clinical trial, 30 participants underwent surgical removal of bilateral impacted mandibular third molars under local anesthesia using ropivacaine 0.75% or lidocaine 2% with 1:100,000 epinephrine. The pain was recorded on a visual analog scale at 4, 8, 12, 24, and 48 h postoperatively. The use of analgesics and the presence of adverse effects were recorded. RESULTS: The duration of soft tissue anesthesia in the ropivacaine group was significantly longer than that in the lidocaine group. The lidocaine group recorded significantly higher visual analog scale scores at all postoperative time intervals, except in the final 48-h period. Analgesic use was higher in the lidocaine group. Rescue medication was used by 2 patients in each group (6.7%). Significantly more postoperative bleeding was seen in the ropivacaine group. CONCLUSION: Ropivacaine 0.75% injection before the surgical procedure may be associated with preventive analgesia for extraction of impacted mandibular third molars.

Buffered 2% articaine versus non-buffered 4% articaine in maxillary infiltration: randomized clinical trial.

OBJECTIVES: This randomized, triple-blind, crossover clinical trial aimed to evaluate the efficacy, onset, length of pulp and soft tissue anesthesia, and pain during injection of 2% buffered articaine and 4% non-buffered articaine solutions. METHODS: Each volunteer received two maxillary supraperiosteal anesthesia infiltrations in canine area. The infiltrations were performed at two different sessions using a different local anesthetic solution for each session, and the anesthetic injection speed was always 1 mL/min. The assessment of the onset and length of pulpal and soft tissue anesthesia was performed with the pulp electrical test "pulp tester" and the esthesiometer kit, respectively. Volunteers marked pain during injection on a visual analog scale (VAS). The anesthetics solutions pH was evaluated through the pH meter equipment. RESULTS: There was no difference between the two anesthetic solutions (onset of soft tissue anesthesia, p = 0.5386; length of soft tissue anesthesia, p = 0.718; onset of pulpal anesthesia, p = 0.747; length of pulpal anesthesia, p = 0.375), except for pain during the injection which was lower when buffered 2% articaine was used (p = 0.001) and the pH. The pH analysis revealed that the solutions differed from one another (p < 0.01). CONCLUSION: The 2% buffered articaine solution provided the same anesthetic properties then 4% unbuffered articaine with a great reduction in pain during injection. CLINICAL RELEVANCE: The possibility of use 2% buffered articaine solution instead of 4% articaine maintaining the same anesthetic properties with a great reduction in pain during injection and half of the anesthetic salt concentration.

Palatal needle-free anesthesia for upper molars extraction. A randomized clinical trial.

BACKGROUND: The aim of this study was to compare the ability of liposomal and non-liposomal lidocaine and prilocaine in hydrogel formulations to promote topical anesthesia in palatal mucosa during upper molar extractions. METHODS: In this randomized, cross over, triple-blinded clinical trial, a liposomal and a non-liposomal formulation of the eutectic mixture of local anesthetics, 2.5% lidocaine and 2.5% prilocaine, were used to promote palatal anesthesia without the local anesthetic infiltration during bilateral upper molars extractions. RESULTS: From the total of 40 patients included in this study, the non-liposomal eutectic lidocaine-prilocaine formulation failed in 40% of cases, unlike the liposomal formulation, which was effective for all patients (Fisher's exact test, p < 0.0001). Furthermore, the liposomal formulation (26.75 ± 7,47 min) induced longer anesthesia duration (t-test, p < 0.0001) than the non-liposomal formulation (16.78 ± 4.75 min). No mucosal ulceration or discomfort was reported for both formulations. CONCLUSION: The liposomal formulation was able to induce adequate anesthesia in palatal mucosa during dental extraction, avoiding the local anesthetic infiltration. For the first time, a topical formulation allowed upper molars surgical removal without injection of any local anesthetic agent into palatal mucosa in adults.

Effect of homeopathy in the function and morphology of salivary parotid glands of irradiated rats / Efeito da homeopatia na função e morfologia das glândulas parótidas de ratos irradiados

Objective: To evaluate the radioprotective effect of a homeopathic solution in salivary function and parotid glands morphology of irradiated rats. Materials and Methods: The sample consisted of 150 rats randomly divided into 6 groups. The groups were named based on the substance administered: Control- saline solution; Irradiated Control- saline solution and 15 Gy of X radiation; Alcohol-hydroalcoholic solution dynamized at 15 CH; Irradiated Alcohol- hydroalcoholic solution dynamized at 15 CH and 15 Gy of X radiation; Homeopathy- 0.25 ml (1mL/kg) of the irradiated hydroalcoholic solution and dynamized at 15 CH; Irradiated homeopathy- homeopathic solution and 15 Gy of X radiation. Each group was subdivided into 5 different subgroups, based on the time point of euthanasia: 12 hours, 3, 10, 17, and 24 days. The medication was administered for 7 days before and 7 days after the radiation treatment. On the day of euthanasia, salivation was induced with pilocarpine and collected. The animals were then sacrificed and the parotid glands were removed. Results: Salivary function analysis showed that only group irradiated homeopathy euthanized on day 17 had a statistically significant difference when compared to other irradiated groups, presenting a higher salivation flow rate. The only group that showed a statistically significant difference in the number of acini over time was the irradiated alcohol group, which presented a tendency of reduction. Conclusion: The homeopathic solution presented a late radioprotective effect based on salivary function and morphological analysis of the parotid gland.

Objetivo: Avaliar o efeito radioprotetor de uma solução homeopática na função salivar e na morfologia das glândulas parótidas de ratos irradiados. Materiais e Métodos: A amostra foi composta por 150 ratos divididos aleatoriamente em 6 grupos. Os grupos foram nomeados com base na substância administrada: solução salina controle; Solução salina controle irradiada e 15 Gy de radiação X; Solução álcool-hidroalcoólica dinamizada a 15 CH; Solução hidroalcoólica de álcool irradiado dinamizada a 15 CH e 15 Gy de radiação X; Homeopatia - 0,25 ml (1mL / kg) da solução hidroalcoólica irradiada e dinamizada a 15 CH; Homeopatia irradiada - solução homeopática e 15 Gy de radiação X. Cada grupo foi subdividido em 5 subgrupos diferentes, com base no tempo da eutanásia: 12 horas, 3, 10, 17 e 24 dias. O medicamento foi administrado por 7 dias antes e 7 dias após o tratamento com radiação. No dia da eutanásia, a salivação foi induzida com pilocarpina e coletada. Os animais foram então sacrificados e as glândulas parótidas foram removidas. Resultados: A análise da função salivar mostrou que apenas a homeopatia irradiada por grupo sacrificada no dia 17 apresentou diferença estatisticamente significante quando comparada a outros grupos irradiados, apresentando maior taxa de fluxo de salivação. O único grupo que apresentou diferença estatisticamente significante no número de ácinos ao longo do tempo foi o grupo álcool irradiado, o qual apontou uma tendência de redução. Conclusão: A solução homeopática apresentou efeito radioprotetor tardio baseado na função salivar e na análise morfológica da glândula parótida.

Antinociceptive and anti-edema properties of the ethyl acetate fraction obtained from extracts of Coriandrum sativum Linn. leaves.

This study evaluated the antinociceptive and anti-edema properties of fractions of Coriandrum sativum Linn. (Apiaceae/Umbelliferae) leaves in mice. Ethyl acetate fractions (FAc) were obtained from dichloromethane extracts prepared from dried C. sativum (CS) leaves and stems. The effects of different concentrations of FAc on mice were observed using the open-field test, formalin-, capsaicin-, and carrageenan-induced paw edema tests, and the acetic acid-induced abdominal writhing test. Results from the carrageenan-induced paw edema test were subjected to a linear regression analysis and data from other assays were subjected to the Kruskal-Wallis test (followed by the SNK post hoc test). Dihydrocoriandrin (34.5%), coriandrin (14.4%), vitamin E (4.6%), and stigmasterol (7.9%) were identified in FAc. The number of squares the mice crossed in the open field test was decreased by 100 mg/kg and 300 mg/kg FAc (i.p.). The administration of 30, 100, and 300 mg/kg FAc induced fewer abdominal writhes than the control. In the formalin test, neurogenic pain was reduced by 20 mg/kg morphine and 30 and 100 mg/kg FAc, but not 5 mg/kg dexamethasone or 10 mg/kg FAc. Formalin-induced inflammatory pain was decreased by morphine, dexamethasone, and 30 and 100 mg/kg FAc. Morphine and 30, 100, and 300 mg/kg FAc significantly decreased the reaction time during the capsaicin test. Dexamethasone reduced both early and later phases of carrageenan-induced edema. Both 30 and 300 mg/kg FAc induced less edema than the control throughout the experiment. FAc showed antinociceptive, anti-edema and anti-inflammatory properties and it may be considered as a potential phytotherapeutic agent in the future.

Effects of passiflora incarnata and midazolam for control of anxiety in patients undergoing dental extraction

BACKGROUND: Anxiety symptoms are frequently observed in dental patients, whether they are undergoing simple or more invasive procedures such as surgery. This research aimed to compare the effects of Passiflora incarnata and midazolam for the control of anxiety in patients undergoing mandibular third molar extraction. MATERIAL AND METHODS: Forty volunteers underwent bilateral extraction of their mandibular third molars in a randomized, controlled, double-blind, crossover clinical trial. Passiflora incarnata (260 mg) or midazolam (15 mg) were orally administered 30 minutes before surgery. The anxiety level of participants was evaluated by questionnaires and measurement of physical parameters, including heart rate (HR), blood pressure (BP), and oxygen saturation (SpO2 ). RESULTS: Considering each procedure independently, there were no significant differences between the protocols in BP, HR, and SpO2 . Over 70% of the volunteers responded that they felt quiet or a little anxious under both protocols. With midazolam, 20% of the participants reported amnesia (not remembering anything at all), while Passiflora showed little or no ability to interfere with memory formation. CONCLUSIONS: Passiflora incarnata showed an anxiolytic effect similar to midazolam, and was safe and effective for conscious sedation in adult patients who underwent extraction of their mandibular third molars

Recent advances and perspectives in topical oral anesthesia.

INTRODUCTION: Topical anesthesia is widely used in dentistry to reduce pain caused by needle insertion and injection of the anesthetic. However, successful anesthesia is not always achieved using the formulations that are currently commercially available. As a result, local anesthesia is still one of the procedures that is most feared by dental patients. Drug delivery systems (DDSs) provide ways of improving the efficacy of topical agents. Areas covered: An overview of the structure and permeability of oral mucosa is given, followed by a review of DDSs designed for dental topical anesthesia and their related clinical trials. Chemical approaches to enhance permeation and anesthesia efficacy, or to promote superficial anesthesia, include nanostructured carriers (liposomes, cyclodextrins, polymeric nanoparticle systems, solid lipid nanoparticles, and nanostructured lipid carriers) and different pharmaceutical dosage forms (patches, bio- and mucoadhesive systems, and hydrogels). Physical methods include pre-cooling, vibration, iontophoresis, and microneedle arrays. Expert opinion: The combination of different chemical and physical methods is an attractive option for effective topical anesthesia in oral mucosa. This comprehensive review should provide the readers with the most relevant options currently available to assist pain-free dental anesthesia. The findings should be considered for future clinical trials.

In vitro effects of Melaleuca alternifolia essential oil on growth and production of volatile sulphur compounds by oral bacteria

ABSTRACT Objective Halitosis can be caused by microorganisms that produce volatile sulphur compounds (VSCs), which colonize the surface of the tongue and subgingival sites. Studies have reported that the use of natural products can reduce the bacterial load and, consequently, the development of halitosis. The aim of this study was to evaluate the antimicrobial activity of the essential oil of Melaleuca alternifolia on the growth and volatile sulphur compound (VSC) production of oral bacteria compared with chlorhexidine. Material and Methods The effects of these substances were evaluated by the Minimum Inhibitory Concentration (MIC) and Minimum Bactericidal Concentration (MBC) in planktonic cultures of Porphyromonas gingivalis and Porphyromonas endodontalis. In addition, gas chromatography analyses were performed to measure the concentration of VSCs from bacterial cultures and to characterize M. alternifolia oil components. Results The MIC and MBC values were as follows: M. alternifolia - P. gingivalis (MIC and MBC=0.007%), P. endodontalis (MIC and MBC=0.007%=0.5%); chlorhexidine - P. gingivalis and P. endodontalis (MIC and MBC=1.5 mg/mL). M. alternifolia significantly reduced the growth and production of hydrogen sulfide (H2S) by P. gingivalis (p<0.05, ANOVA-Dunnet) and the H2S and methyl mercaptan (CH3SH) levels of P. endodontalis (p<0.05, ANOVA-Dunnet). Chlorhexidine reduced the growth of both microorganisms without altering the production of VSC in P. endodontalis. For P. gingivalis, the production of H2S and CH3SH decreased (p<0.05, ANOVA-Dunnet). Conclusion M. alternifolia can reduce bacterial growth and VSCs production and could be used as an alternative to chlorhexidine.

Development and Evaluation of a Novel Mucoadhesive Film Containing Acmella oleracea Extract for Oral Mucosa Topical Anesthesia.

PURPOSE: To develop an anesthetic mucoadhesive film containing Acmella oleracea (jambu) extract for topical use on oral mucosa. METHODS: Ethanolic extracts from aerial parts of jambu were prepared by maceration. Pigment removal was obtained by adsorption with activated carbon. Three mucoadhesive films were developed using a film casting method: 10 or 20% of crude jambu extract (10% JB and 20% JB), and 10% of crude jambu extract treated with activated carbon (10% JBC). The mucoadhesive films were characterized regarding their uniformity, thickness, pH, and spilanthol content, and their stability was evaluated during 120 days. Gas chromatography was used to quantify the amount of spilanthol. In vitro tests determined the permeation of spilanthol across pig esophageal epithelium mucosa in Franz diffusion cells. Topical anesthetic efficacy was assessed in vivo using a tail flick test in mice. RESULTS: The three mucoadhesive films showed physical stability and visual appearances suitable for use on oral mucosa. The permeation study revealed that the spilanthol from 10% JBC presented higher flux and permeability coefficient values, compared to 10% or 20% JB (p < 0.001). Moreover, 10% JBC showed better topical anesthetic efficacy than the other films (p < 0.01). CONCLUSION: Mucoadhesive film containing crude extract of jambu treated with activated carbon is a potential alternative for oral, topical use, encouraging future clinical studies.

Evaluation of different pig oral mucosa sites as permeability barrier models for drug permeation studies.

The objective of the present study was to investigate the influence of preparation and storage conditions on the histology and permeability of different parts of porcine oral mucosa used for in vitro studies of transbuccal formulations. Fresh and frozen (-20°C and -80°C, with or without cryoprotectant) epithelia of porcine palatal, gingival, dorsum of the tongue, and buccal mucosa were submitted for histological analyses to determine the effects of storage conditions on barrier integrity. Permeation of lidocaine hydrochloride (used as a hydrophilic model drug) across fresh and previously frozen oral epithelium was measured in order to evaluate the barrier function. Histological evaluation demonstrated that the oral epithelium was successfully separated from the connective tissue, except for gingival mucosa. After storage under different conditions, all tissues presented desquamation of superficial layers and spherical spaces induced by the freezing process. The permeability of lidocaine hydrochloride varied among the fresh oral mucosa and generally increased after freezing. In conclusion, fresh epithelium from the buccal and dorsum of the tongue mucosa should be used for in vitro studies investigating hydrophilic drug transport when these are the desired clinical application sites. However, when the palate is the target site, both fresh and frozen (for up to 4weeks, without addition of cryoprotectant) samples could be used. The addition of glycerol as a cryoprotectant should be avoided due to increased lidocaine hydrochloride permeability.

In vitro effects of Melaleuca alternifolia essential oil on growth and production of volatile sulphur compounds by oral bacteria.

OBJECTIVE: Halitosis can be caused by microorganisms that produce volatile sulphur compounds (VSCs), which colonize the surface of the tongue and subgingival sites. Studies have reported that the use of natural products can reduce the bacterial load and, consequently, the development of halitosis. The aim of this study was to evaluate the antimicrobial activity of the essential oil of Melaleuca alternifolia on the growth and volatile sulphur compound (VSC) production of oral bacteria compared with chlorhexidine. MATERIAL AND METHODS: The effects of these substances were evaluated by the Minimum Inhibitory Concentration (MIC) and Minimum Bactericidal Concentration (MBC) in planktonic cultures of Porphyromonas gingivalis and Porphyromonas endodontalis. In addition, gas chromatography analyses were performed to measure the concentration of VSCs from bacterial cultures and to characterize M. alternifolia oil components. RESULTS: The MIC and MBC values were as follows: M. alternifolia - P. gingivalis (MIC and MBC=0.007%), P. endodontalis (MIC and MBC=0.007%=0.5%); chlorhexidine - P. gingivalis and P. endodontalis (MIC and MBC=1.5 mg/mL). M. alternifolia significantly reduced the growth and production of hydrogen sulfide (H2S) by P. gingivalis (p<0.05, ANOVA-Dunnet) and the H2S and methyl mercaptan (CH3SH) levels of P. endodontalis (p<0.05, ANOVA-Dunnet). Chlorhexidine reduced the growth of both microorganisms without altering the production of VSC in P. endodontalis. For P. gingivalis, the production of H2S and CH3SH decreased (p<0.05, ANOVA-Dunnet). CONCLUSION: M. alternifolia can reduce bacterial growth and VSCs production and could be used as an alternative to chlorhexidine.

Liposomal lidocaine gel for topical use at the oral mucosa: characterization, in vitro assays and in vivo anesthetic efficacy in humans.

OBJECTIVE: To characterize liposomal-lidocaine formulations for topical use on oral mucosa and to compare their in vitro permeation and in vivo anesthetic efficacy with commercially available lidocaine formulations. MATERIALS AND METHODS: Large unilamellar liposomes (400 nm) containing lidocaine were prepared using phosphatidylcholine, cholesterol, and α-tocoferol (4:3:0.07, w:w:w) and were characterized in terms of membrane/water partition coefficient, encapsulation efficiency, size, polydispersity, zeta potential, and in vitro release. In vitro permeation across pig palatal mucosa and in vivo topical anesthetic efficacy on the palatal mucosa in healthy volunteers (double-blinded cross-over, placebo controlled study) were performed. The following formulations were tested: liposome-encapsulated 5% lidocaine (Liposome-Lido5); liposome-encapsulated 2.5% lidocaine (Liposome-Lido2.5); 5% lidocaine ointment (Xylocaina®), and eutectic mixture of lidocaine and prilocaine 2.5% (EMLA®). RESULTS: The Liposome-Lido5 and EMLA showed the best in vitro permeation parameters (flux and permeability coefficient) in comparison with Xylocaina and placebo groups, as well as the best in vivo topical anesthetic efficacy. CONCLUSION: We successfully developed and characterized a liposome encapsulated 5% lidocaine gel. It could be considered an option to other topical anesthetic agents for oral mucosa.

Effect of Erythrina mulungu on anxiety during extraction of third molars

OBJECTIVES: The aim of the present study was to evaluate the effect of Erythrinamu lungu on the control of dental anxiety in patients who had under gone bilateral extraction of asymptomatic, impacted mandibular third molars. MATERIAL AND METHODS: In a randomized, double-blind, crossover study, 30 healthy volunteers (5 men and 25 women, over 18 years of age), received either 500mg of E.mulungu (Mulungu Matusa(R)) or 500 mg of placebo, p.o., one hour before surgical procedure. The level of anxiety was assessed through questionnaire sand physical parameters, such as blood pressure, heart rate and oxygen saturation. Data were analyzed by Chi-square test, ANOVA (Tukey test) and Friedman with significance level of 5%. RESULTS:A higher preference (Chi-square, p = 0.0062) for E. mulungu was observed for both genders. Volunteers with higher anxiety levels tended to to prefer E. mulungu. No statistically significant differences were verified in blood pressure (one-way ANOVA, p = 0.1259), heart rate (Friedman, p > 0.05) and oxygen saturation (Friedman, p = 0.7664) among periods and types of treatments. CONCLUSIONS: E. mulungu showed an anxiolytic effect without significant changes in physiological parameters. It could be considered as an alternative to control the anxiety in adult patients undergoing mandibular third molars surgery

Effect of Erythrinamu lungu on anxiety during extraction of third molars.

OBJECTIVES: The aim of the present study was to evaluate the effect of Erythrinamu lungu on the control of dental anxiety in patients who had under gone bilateral extraction of asymptomatic, impacted mandibular third molars. MATERIAL AND METHODS: In a randomized, double-blind, crossover study, 30 healthy volunteers (5 men and 25 women, over 18 years of age), received either 500mg of E.mulungu (MulunguMatusa®) or 500 mg of placebo, p.o., one hour before surgical procedure. The level ofanxiety was assessed through questionnaire sand physical parameters, such as blood pressure, heart rate andoxygen saturation. Data were analyzed by Chi-square test, ANOVA (Tukey test) and Friedman with significance level of 5%. RESULTS: A higher preference (Chi-square, p = 0.0062) for E. mulungu was observed for both genders. Volunteers with higher anxiety levels tended to to prefer E. mulungu. No statistically significant differences were verified in blood pressure (one-way ANOVA, p = 0.1259), heart rate (Friedman, p> 0.05) and oxygen saturation (Friedman, p = 0.7664) among periods and types of treatments. CONCLUSIONS: E. mulungu showed an anxiolytic effect without significant changes in physiological parameters. It could be considered as an alternative to control the anxiety in adult patients undergoing mandibular thirdmolars surgery.

Vellozia flavicans Mart. ex Schult. hydroalcoholic extract inhibits the neuromuscular blockade induced by Bothrops jararacussu venom.

BACKGROUND: Snakebite is a significant public health issue in tropical countries. In Brazil, some of the most common snake envenomations are from Bothrops. Bothrops bites trigger local and systemic effects including edema, pain, erythema, cyanosis, infections, and necrosis. Vellozia flavicans is a plant from the Brazilian "cerrado" (savanna) that is popularly used as an anti-inflammatory medicine. Since inflammation develops quickly after Bothrops bites, which can lead to infection, the aim of the present study was to observe possible anti-snake venom and antimicrobial activities of V. flavicans (Vf). METHODS: The chromatographic profile of the main constituents from the Vf leaf hydroalcoholic extract was obtained by thin-layer chromatography (TLC). The anti-snake venom activity was measured by Vf's ability to neutralize the in vitro neuromuscular blockade caused by Bothrops jararacussu venom (Bjssu) in a mouse phrenic nerve-diaphragm model (PND). After a 20 min incubation, preparations of PND were added to Tyrode's solution (control); Vf (0.2, 0.5, 1, and 2 mg/mL); 40 µg/mL Bjssu; pre-incubation for 30 min with Bjssu and 1 mg/mL Vf; and a Bjssu pretreated preparation (for 10 min) followed by 1 mg/mL Vf. Myographic recording was performed, and the contractile responses were recorded. The antimicrobial activity (minimum inhibitory concentration [MIC] and minimum bactericidal concentration [MBC]) was obtained for Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, and Enterococcus faecalis, using gentamicin and vancomycin as positive controls. RESULTS: TLC analysis yielded several compounds from Vf, such as flavonoids (quercetin) and phenolic acids (chlorogenic acid). Bjssu completely blocked the contractile responses of PND preparations, while Vf preserved 97% (±10%) of the contractile responses when incubated with Bjssu. In the PND pretreated with Bjssu, Vf was able to inhibit the neuromuscular blockade progress. MIC and MBC of Vf ranged from 2.5 to 5.0 mg/mL for P. aeruginosa and S. aureus strains, while no antimicrobial activity was observed for E. coli and E. faecalis. CONCLUSIONS: The hydroalcoholic extract from Vf leaves was able to neutralize and decrease the in vitro neuromuscular blockade caused by Bjssu. However, it did not show significant antimicrobial activity against the tested bacteria.

Phototherapy and resistance training prevent sarcopenia in ovariectomized rats.

The aim of this study was to histologically and biochemically analyze the effects of light-emitting diode therapy (LEDT) associated with resistance training to prevent sarcopenia in ovariectomized rats. Forty female Wistar rats (12 months old, 295-330 g) were bilaterally ovariectomized and divided into four groups (n = 10 per group): control-sedentary (C), resistance training (T), LEDT-sedentary (L), and LEDT plus resistance training (LT). Trained rats performed a 12-week water-jumping program (3 days per week) carrying a load equivalent to 50-80% of their body mass strapped to their back. Depending on the group protocol, the LED device (850 nm, 100 mW, 120 J/cm(2), spot size 0.5 cm(2)) was used either as the only method or after the resistance training had been performed. The device was used in the single point contact mode (for 10 min). The irradiated region was the center of the greater trochanter of the right femur and the middle third of the rectus femoris muscle was subsequently analyzed histomorphometrically. Significant increases (p < 0.05) were noted for the muscle volume of the T (68.1 ± 19.7%), the L (74.1 ± 5.1%), and the LT (68.2 ± 11.5%) groups compared to the C group (60.4 ± 5.5%). There were also significant increases in the concentrations of IGF-1, IL-1, and TNF-α in the muscles of the treated groups (p < 0.05). Animals in the LT group showed a significant increase in IL-6 compared to T, L, and C groups (p < 0.05). These findings suggest that resistance training and LEDT can prevent sarcopenia in ovariectomized rats.

Liposomal-benzocaine gel formulation: correlation between in vitro assays and in vivo topical anesthesia in volunteers.

The aim of the present study was to characterize a liposome-based benzocaine (BZC) formulation designed for topical use on the oral mucosa and to evaluate its in vitro retention and permeation using the Franz-type diffusion cells through pig esophagus mucosa. To predict the effectiveness of new designed formulations during preclinical studies, a correlation between in vitro assays and in vivo efficacy was performed. Liposomal BZC was characterized in terms of membrane/water partition coefficient, encapsulation efficiency, size, polydispersity, zeta potential, and morphology. Liposomal BZC (BL10) was incorporated into gel formulation and its performances were compared to plain BZC gel (B10) and the commercially available BZC gel (B20). BL10 and B10 presented higher flux and retention on pig esophagus mucosa with a shorter lag time, when compared to B20. BZC flux was strongly correlated with in vivo anesthetic efficacy, but not with topical anesthesia duration. The retention studies did not correlate with any of the in vivo efficacy parameters. Thus, in vitro permeation study can be useful to predict anesthetic efficacy during preclinical tests, because a correlation between flux and anesthetic efficacy was observed. Therefore, in vitro assays, followed by in vivo efficacy, are necessary to confirm anesthetic performance.