Photobiomodulation in the Treatment of Dysgeusia in Patients with Long COVID: A Single-Blind, Randomized Controlled Trial.

Objective: The aim of this study is to evaluate local and systemic photobiomodulation (PBM) in patients with COVID-19-related dysgeusia, with the expectation of improving taste dysfunction. Background: PBM has garnered attention as a potential therapy in long COVID, a condition characterized by many persistent symptoms following the acute phase of COVID-19. Among these symptoms, dysgeusia, or altered taste perception, can significantly affect patients' quality of life. Emerging research suggests that PBM may hold promise in ameliorating dysgeusia by modulating cellular processes and reducing inflammation. Further clinical studies and randomized controlled trials are essential to establish the efficacy and safety of PBM for the treatment of dysgeusia in long COVID, but initial evidence suggests that this noninvasive modality may offer a novel avenue for symptom management. Methods: Seventy patients experiencing dysgeusia were randomly assigned to receive active local and systemic PBM (n = 34) or simulated PBM (n = 36). Low-power laser (red wavelength) was used at 18 spots on the lateral borders of the tongue (3 J per spot), salivary glands (parotid, sublingual, and submandibular glands-3 J per spot), and over the carotid artery for 10 min (60 J). Alongside laser therapy, all patients in both groups received weekly olfactory therapy for up to 8 weeks. Results: Dysgeusia improved in both groups. At weeks 7 and 8, improvement scores were significantly higher in the PBM group than in the sham group (p = 0.048). Conclusions: Combined local and systemic PBM, as applied in this study, proved effective and could serve as a viable treatment option for alleviating dysgeusia in long-COVID patients. Clinical Trial Registration: RBR-2mfbkkk.

Dog-assisted therapy for control of anxiety in pediatric dentistry.

Anxiety is common in pediatric dental care, and affects the behavioral management of children. Animal-assisted therapy (AAT) has been shown to improve children's behavior. However, few studies have applied this technique in dentistry. The aim of the present study was to evaluate the applicability of dog-assisted therapy to control anxiety during pediatric dental treatment. Twenty children were selected from the Pediatric Dentistry Clinic of the Pontifical Catholic University of Campinas (PUC-Campinas), Brazil. Participants were divided into two groups: Control (n = 11; visits = 16), in which children were conditioned by methods routinely used in the clinic; and AAT (n = 9; visits = 23), in which children had contact with a dog therapist first at the reception desk and then again inside the office. The dog therapist stayed beside the dental chair with the child throughout the procedures. Corah's Dental Anxiety Scale (CS) and heart rate (HR) were used for evaluation of child anxiety. The results were tested for normality of distribution with the Shapiro-Wilk method, and subsequently analyzed in BioEstat 5.0. HR results were compared by Analysis of Variance (ANOVA) with Tukey's test, and CS scores, with the Wilcoxon test. There was a significant reduction in HR in the AAT group (p = 0.0069). In the Control group, HR did not change before, during, or after treatment (p = 0.6052). Controls showed a significant increase in anxiety measured by CS before and after treatment (p = 0.0455). In the AAT group, there was no change in CS scores before and after treatment (p = 0.3739). AAT could be an alternative to reduce anxiety during pediatric dental care.

Photobiomodulation for Pain Relief After Third Molar Extraction: A Randomized Double-Blind Split-Mouth Clinical Trial.

Objective: To evaluate the local and systemic application of photobiomodulation (PBM) to reduce pain after third molar extraction. Background: PBM has been applied locally to reduce pain after third molar extraction, but there are no published studies evaluating its systemic application for this purpose. Methods: Thirty patients with two erupted third molars indicated for extraction were included in this split-mouth clinical trial. Extractions were performed 3 weeks apart in each patient, with one extraction socket being randomly assigned to local and systemic PBM (PBM group) and the other to no PBM (control group). Postoperative analgesia consisted of oral acetaminophen for 3 days. Outcomes included pain (visual analog scale), swelling, and quality of life (14-item Oral Health Impact Profile) assessed before and immediately, 24 h, 48 h, and 7 days after extraction. Results were analyzed by Kruskal-Wallis test, followed by Student-Newman-Keuls test. Results: In the control group, pain increased significantly at 24 and 48 h after extraction (p = 0.0000), decreasing after 7 days (before: 0.36; immediately after: 1.06; 24 h: 4.26; 48 h: 2.53; 7 days: 0.36). In the PBM group, patients reported no pain at all time points, indicating effectiveness of local and systemic PBM in relieving pain after third molar extraction (p = 0.2151) (before: 0.30; immediately after: 0.36; 24 h: 0.86; 48 h: 0.30; 7 days: 0.03). PBM also had a modulatory effect on the inflammatory process and improved comfort after extraction. Conclusions: Combined local and systemic PBM can be useful for pain relief, swelling control, and quality-of-life improvement in patients undergoing third molar extraction.

Photobiomodulation for the management of xerostomia and oral mucositis in patients with cancer: a randomized clinical trial.

To evaluate the applicability of photobiomodulation therapy (PBM-T) in the management of xerostomia and OM. Fifty-three patients with head and neck squamous cell carcinoma were randomized into two groups: Sham and PBM-T. The Sham group received artificial saliva and laser simulation, while the PBM-T group received artificial saliva and PBM-T. Xerostomia-related quality of life (QoL), the presence or absence of OM lesions, the decayed-missing-filled teeth (DMFT) index, and periodontal charts were evaluated. The results of the QoL questionnaire, DMFT index, and periodontal chart were analyzed with the Kruskal-Wallis test, followed by the Student-Newman-Keuls test, while OM findings were compared using the Mann-Whitney test. QoL scores significantly increased in the Sham group (p < 0.0001), denoting more severe xerostomia symptoms (p = 0.0074), and decreased in the PBM-T group, indicating no or very mild xerostomia. Higher grades of OM were found in the Sham group than the PBM-T group (p = 0.0001). There was no significant difference in DMFT index or periodontal charts between the groups (p > 0.05). PBM-T improved QoL in patients with head and neck cancer treated with radiotherapy, whether as radiation alone or as an adjunct to chemotherapy and surgery.

Fisioterapia com brinquedos e terapia assistida por cães em lactentes: estudo observacional / Fisioterapia con juguetes y terapia asistida por perros en lactantes: un estudio observacional / Physical therapy with toys and dog-assisted therapy in infants: observational study

RESUMO O objetivo deste trabalho foi comparar a fisioterapia com brinquedos com a terapia assistida por cães no desenvolvimento neuromotor de lactentes de quatro meses de idade com e sem alterações neuromotoras. Trata-se de pesquisa descritiva e observacional de caráter qualitativo, realizada com 10 lactentes, que foram avaliados pela escala motora infantil de Alberta (EMIA), divididos em grupo 1 (G1) e grupo 2 (G1) e subdivididos em grupo brinquedo (G1B e G2B) e grupo cão (G1C e G2C) para a realização das intervenções quinzenais. O questionário Affordances in the Home Environment for Motor Development - Infant Scale (AHEMD-IS) foi escolhido para avaliar as oportunidades presentes no ambiente domiciliar. A análise de dados qualitativos foi feita por meio de fotos e filmagens. A presença do cão nos grupos G1C e G2C resultou em um ambiente descontraído e divertido, interesse dos lactentes em tocar o pelo do animal, movimentos alternados de membros, contato visual, emissão de sons, evolução na interação social e sentimento de segurança. Nos grupos G1B e G2B, constatou-se diminuição da motivação, ausência de emissão de sons pelos lactentes e contato visual e interesse pelo toque restrito a brinquedos que tivessem diversas cores e sons, havendo pouca agitação e motivação para as habilidades motoras nesses grupos. Conclui-se que a presença do cão promoveu melhores resultados motores, sociais, afetivos e cognitivos. A terapia assistida por animais pode ser um método eficaz para auxiliar na fisioterapia convencional de lactentes com atraso no desenvolvimento neuropsicomotor.

RESUMEN El objetivo de este estudio fue comparar la fisioterapia con juguetes con la terapia asistida por perros en el desarrollo neuromotor de los lactantes de cuatro meses con y sin trastornos neuromotores. Se trata de una investigación cualitativa, descriptiva y observacional, realizada con 10 lactantes, quienes fueron evaluados por la escala motora infantil de Alberta (EMIA), divididos en grupo 1 (G1) y grupo 2 (G1), y subdivididos en grupo juguete (G1J y G2J) y el grupo con perro (G1P y G2P) para realizar las intervenciones quincenales. El cuestionario Affordances in the Home Environment for Motor Development - Infant Scale (AHEMD-IS) se aplicó para evaluar las oportunidades presentes en el entorno domiciliario. El análisis de los datos cualitativos se realizó a partir de fotografías y filmaciones. La presencia del perro en los grupos G1P y G2P resultó en un ambiente relajado y divertido, interés de los lactantes por tocar el pelaje del animal, alternancia de movimientos de las extremidades, contacto visual, emisión de sonidos, evolución en la interacción social y sensación de seguridad. En los grupos G1J y G2J hubo disminución de la motivación, ausencia de emisión de sonidos por parte de los lactantes y contacto visual e interés por el tacto restringido a los juguetes que tenían diferentes colores y sonidos, además de haber poca agitación y motivación para la motricidad en estos grupos. Se concluyó que la presencia del perro promovió mejores resultados motrices, sociales, afectivos y cognitivos. La terapia asistida por animales puede ser un método eficaz para ayudar en la fisioterapia convencional para los lactantes con retraso en el desarrollo neuropsicomotor.

ABSTRACT This study aimed to compare physical therapy with toys with dog-assisted therapy in the neuromotor development of 4-month-old infants with and without neuromotor alterations. This is a qualitative descriptive and observational study carried out with 10 infants, who were evaluated by the Alberta Infant Motor Scale, divided into Group 1 (G1) and Group 2 (G1), and subdivided into Toy Group (TG1 and TG2) and Dog Group (DG1 and DG2) for the performance of fortnightly interventions. By the Affordances in the Home Environment for Motor Development - Infant Scale, we assessed the opportunities present in the home environment. Qualitative data were analyzed using photos and videos. The presence of a dog in DG1 and DG2 resulted in a relaxed and fun environment, infants interested in touching the animal's fur, alternating limb movements, eye contact, sound production, increased social interaction, and feeling of security. In TG1 and TG2, decrease in motivation was observed as well as the absence of sound production and eye contact by infants, and interest in touch restricted to toys that had different colors and sounds, with little agitation and motivation for motor skills in those groups. We concluded that the dog's presence promoted better motor, social, affective, and cognitive results. Animal-assisted therapy can be an effective method to support conventional physical therapy for infants with delayed neuropsychomotor development.

In vitro evaluation of EDTA combined with photodynamic therapy to reduce Streptococcus mutans in carious dentin.

BACKGROUND: This in vitro study aimed to evaluate the use of EDTA combined with photodynamic therapy to reduce Streptococcus mutans in carious dentin. METHODS: Sixty third molars were sectioned to obtain flat dentin surfaces. All specimens were waterproofed, except for the coronal dentin, and subjected to cariogenic challenge in brain-heart infusion (BHI) broth supplemented with 0.5% yeast extract, 1% glucose, 1% sucrose, and standard strain of S. mutans (ATCC 25175). The specimens were divided into 6 groups (n = 10 each): (1) control - caries collection; (2) EDTA - 17% EDTA was actively applied with a microbrush for 1 min; (3) aPDT - antimicrobial photodynamic therapy with 0.01% methylene blue photosensitizer (wavelength of 660 nm, energy of 4 J, power of 100 mW, spot size of 0.028 cm2, energy density of 142 J/cm2 for 40 s); (4) EDTA+aPDT - 17% EDTA actively applied for 1 min plus aPDT; (5) (EDTA+PT) + L - application of EDTA compounded with photosensitizer plus laser irradiation; and (6) PT - photosensitizer alone. Collection of caries was performed after the different cavity disinfection protocols. Aliquots from each dilution were seeded for colony-forming unit (CFU) counts. The results were log10-transformed and analyzed by the Kruskal-Wallis test (Student-Newman-Keuls). RESULTS: There was a significant reduction in S. mutans after aPDT (p<0.05), EDTA+aPDT (p<0.001), and (EDTA+PT) + L (p<0.001). The percentage of microbial reduction in ascending order was as follows: EDTA: 1.65%; PT: 15.51%; aPDT: 38.28%; EDTA+aPDT: 75.24%; and (EDTA+PT) + L: 97.35%. CONCLUSION: Application of 17% EDTA prior to photosensitization or compounded with a photosensitizer increased the antimicrobial effect of aPDT on S. mutans in carious dentin.

Clinical Evaluation of Intravascular Blood Irradiation with Laser, Photobiomodulation, and Photodynamic Therapy in Cancer Patients with Mucositis.

Objective: To assess the clinical application of intravascular laser irradiation of blood (ILIB), photodynamic therapy (PDT), and photobiomodulation therapy (PBM-T) in mucositis in cancer patients. Background: PBM-T and PDT are used for the management of oral mucositis (OM) and there are no studies associating intravascular laser irradiation of blood (ILIB) for this purpose. Materials and methods: Thirty-six patients were allocated by convenience into three groups according to the established therapy: PDT+PBM-T (n = 10); PDT+PBM-T+ILIB (n = 10), and ILIB (n = 16). PDT was performed with the photosensitizer curcumin and irradiation of the oral cavity with blue light-emitting diode (LED) (power 1200 mW and wavelength 468 nm). PBM-T was performed using low-intensity laser (power 100 mW, wavelength 660 nm, and spot energy 1 J) at 26 points of the oral cavity. ILIB was applied with a bracelet on the radial artery using the low-intensity laser (100 mW of power, 660 nm wavelength, and 30 J of total energy). All therapies were performed weekly for 5 weeks. The results of the OM degrees were analyzed using the Wilcoxon test. Results: There was a significant reduction in the degrees of OM after treatment with PDT+PBM-T (p = 0.0117), PDT+PBM-T+ILIB (p = 0.0277), and ILIB (p = 0.0277). Conclusions: It was concluded that ILIB, PDT, and PBM-T reduced the severity of mucositis and prevented its onset. Clinical Trial Registration number: RBR-54XS25.

Photobiomodulation and photodynamic therapy for the treatment of oral mucositis in patients with cancer.

BACKGROUND: Photobiomodulation therapy (PBM-T) can penetrate soft tissues and exert analgesic and healing effects, and is thus a promising alternative for prevention and treatment of oral mucositis (OM). The aim of this study was to evaluate the efficacy of PBM-T, alone or combined with photodynamic therapy (PDT), for treatment of OM in cancer patients. METHODS: Fifty-six patients were recruited from the Oncology Department of a teaching hospital. Patients underwent grading of OM and were divided into two groups (n = 28 each): PBM-T and PBM-T + PDT. In the PBM-T group, low-level laser was applied to 61 points in the oral cavity, once weekly for 4 weeks (wavelength 660 nm, power 100 mW, energy density 142 J/cm², spot energy 4 J, irradiation time 40 s). In the PBM-T + PDT group, in addition to PBM-T as described above, patients rinsed with 20 ml of photosensitizing mouthwash (curcumin 1.5 g/L) and the oral cavity was irradiated with a blue (468 nm) LED for 5 min. RESULTS: Significant reductions in OM grade were observed after application of PBM-T or PBM-T + PDT (p < 0.0001). PBM-T + PDT resulted in a shorter time to resolution of lesions compared to PBM-T alone (p = 0.0005). CONCLUSIONS: PBM-T, alone or combined with PDT, can be used for the treatment of OM. PDT + PBM-T in particular accelerated the OM healing process, reducing time to lesion remission from 15 to 11 days.

Effect of music on reducing anxiety in children during dental treatment / Avaliação do impacto da música como redutor de ansiedade no atendimento odontológico de crianças

ABSTRACT Objective: The objective of this study was to evaluate the impact of music on anxiety in children during dental care Methods: A total of 40 children 5 to 11 years old were selected; they were randomized into 2 groups (n = 20): group 1: experimental, children were subjected to music therapy; group 2: control, children were not subjected to music therapy. We measured oxygen saturation, heart rate and levels of Corah anxiety scale and pain scale. The results for heart rate were evaluated by ANOVA. The Kruskal Wallis (Dunn) test was used to evaluate the oxygen saturation results and the Wilcoxon test for Corah anxiety and pain scores Results: There was a significant decrease in heart rate (pulse) in children who listened to music during dental treatment (p = 0.05). In the group without music, heart rate remained unchanged throughout the care (p = 0.53). There was no significant difference in oxygen saturation or Corah anxiety and pain scores in children who listened to music during dental care (p > 0.05) Conclusion: It can be concluded that music is a non-pharmacological alternative that reduces anxiety levels in children during dental treatment.

RESUMO Objetivo: O objetivo desse trabalho foi avaliar o impacto da música como redutor de ansiedade no atendimento odontológico de crianças. Métodos: Foram selecionadas 40 crianças na Clínica Infantil da Faculdade de Odontologia da PUC-Campinas com a faixa etária variando entre 5 a 11 anos de idade, distribuídas de forma randomizada em 2 grupos (n = 20): grupo 1: experimental, as crianças foram submetidas à terapia musical; grupo 2: controle, as crianças não foram submetidas à terapia musical. As crianças foram acolhidas na recepção e orientadas quanto ao procedimento. Foram feitas a aferição da saturação de oxigênio, frequência cardíaca, aplicação da escala de ansiedade de Corah e escala de dor. Os resultados da frequência cardíaca foram submetidos ao teste de ANOVA. Foram aplicados os testes não paramétricos de Kruskal Wallis (Dunn) para avaliação dos resultados da saturação de oxigênio e o teste de Wilcoxon para os resultados da escala de ansiedade de Corah e de dor. A significância foi de 5%. Resultados: Houve redução significante na frequência cardíaca (pulso) nas crianças que escutaram música durante o atendimento odontológico (p = 0.05). No grupo sem música, a frequência cardíaca manteve-se inalterada durante todo o atendimento (p = 0.53). Não houve diferença significante na saturação de oxigênio, escala de ansiedade de Corah e de dor nas crianças que escutaram ou não a música durante o atendimento odontológico (p > 0.05). Conclusão: Pode-se concluir que a música é uma alternativa não farmacológica que reduz os níveis de ansiedade na criança durante o tratamento odontológico.

Photobiomodulation Therapy in Cancer Patients with Mucositis: A Clinical Evaluation.

Objective: To evaluate the use of photobiomodulation therapy (PBM-T) in patients undergoing chemotherapy and/or radiotherapy and affected by oral mucositis (OM). Background: Few clinical studies have evaluated PBM-T, particularly in combination with photodynamic therapy (PDT), for the treatment of OM. Methods: Thirty-one patients were divided by convenience into two groups. One received PBM-T (n = 17) alone, consisting of low-intensity laser (LIL) irradiation (wavelength 660 nm, continuous mode, spot energy 4 J, energy density 142 J/cm2, irradiation time 40 s per spot), once weekly for 4 weeks. The other (n = 14) received a combination of PBM-T and PDT, with curcumin as photosensitizer. Patients were instructed to rinse their mouth with 20 mL of curcumin solution for 5 min. The oral cavity was irradiated with a blue light-emitting diode (power 1200 mV, wavelength 468 nm) for 5 min. LIL was applied as in the PBM-T group. After treatment, OM severity was reassessed. The results were analyzed by the Wilcoxon and Mann-Whitney tests. Results: Both PBM-T alone and PBM-T+PDT yielded significant reductions in OM grade (p < 0.01). PDT+PBM-T resulted in a significantly shorter healing time compared with PBM-T alone (p = 0.0321). Conclusions: Within the parameters of this study, PBM-T+PDT was an effective method to accelerate the OM healing process.

Avaliação dos métodos de higienização sobre S. mutans dos protetores bucais / Evaluation of cleaning methods on custom-made mouthguards of S. mutans

Objetivo: avaliar a eficácia de três diferentes métodos de higienização sobre cepas de S.mutans dos protetores bucais feitos sob medida: dentifrício fluoretado, detergente neutro eclorexidina. Materiais e Métodos: foram confeccionados 30 protetores bucais feitos sob medida com placas de silicone de 3 mm que foram contaminados em meio de sobrevivência BHI (BrainHeart Infusion) suplementado com 1% de glicose e sacarose e 0,5% de extrato de levedura e incubados em jarra de anaerobiose a 37°C em estufa bacteriológica por 15 dias. O meio foi renovado a cada 24 horas. Após a contaminação, foi feita a coleta dos protetores bucais, esfregaço e plaqueamento na superfície do meio de cultura mitis salivarius com bacitracina. Os protetores foram higienizados com escova dental, com três diferentes meios de higienização:dentifrício fluoretado, detergente neutro e clorexidina e, após a higienização foram submetidos a uma nova coleta, esfregaço e plaqueamento. Após incubação, foi feita a contagem do total de bactérias viáveis. Os resultados obtidos foram submetidos à análise estatística e ao teste não paramétrico de Wilcoxon. Resultados: houve redução microbiana significativa da contagem deS. mutans utilizando clorexidina e detergente (p<0.05). Não houve diferença significante na contagem antes e depois utilizando o dentifrício (p>0.05). Conclusão: a clorexidina e o detergente podem ser utilizados para desinfecção dos protetores bucais.

Objective: The effect of three different cleaning methods on custom-made mouth guards’strains of S. mutans: fluoridated tooth paste, neutral detergent and chlorhexidine. Materials and Methods: it were made 30 mouthguards custom-made with 3mm silicone slabs that have been subjected to a microbiological processing in supplemented BHI (Brain Heart Infusion). They were in cubated in anaerobic jar at 37 ° bacteriological green house for 15 days, changing the medium every 24 hours. After the contamination, samples were drawn and it was made the collection, smear and plating on surface of the culture medium mitis salivarius with bacitracin and then they were cleaned with tooth brush with three different modes of cleaning: chlorhexidine, neutral detergent and fluoridated tooth paste. After incubation, the count was made of total viable bacteria. The results were statistically analyzed by the Wilcoxon non-parametric test. Results: there wasa significant reduction in microbial counts before and after using chlorhexidine and detergent (p<0.05). There wasn’t significant difference in the count before and after using the tooth paste(p>0.05). Conclusion: chlorhexidine and detergent can be used for disinfection of mouth guards

Efeito do laser de baixa potência na dor após a montagem do aparelho ortodôntico / Effect of low level laser for pain relief after the first orthodontic archwire’s placement

Objetivo: avaliar clinicamente a eficácia da Terapia de Laser de Baixa Potência (TLBP) no alívio da dor após a instalação do aparelho ortodôntico e primeiro arco. Materiais e Métodos: 90 voluntários receberam aparelho fixo e colocação do primeiro arco ortodôntico. Foram randomicamente divididos em três grupos: Grupo 1- Controle (n=30), Grupo 2 - Placebo (n=30) e Grupo 3 - Laser (n=30). Foi realizada a TLBP infravermelho (810 nm) com 100 mW de potência e dose de 6 J/cm2 divididas em quatro aplicações por dente. A dor foi avaliada utilizando Escala Visual Analógica (EVA). Os dados obtidos foram submetidos à análise estatística por meio de teste de Kruskal- Wallis (α=0,05). Resultados: Em todos os grupos analisados a dor iniciou-se após 2 horas, houve um pico de dor entre 12 horas e 48 horas e sua diminuição ocorreu em sete dias. O Grupo 3 (Laser) apresentou todos os valores de dor menores em relação aos valores observados nos outros grupos. Houve diferença estatisticamente significante (p<0,05) da dor pós-operatória entre 12 e 48 horas (momento de pico de dor) para o grupo 3 em relação aos grupos 1 e 2. Conclusão: A TLBP mostrou-se eficiente para a redução da dor após a colocação do aparelho fixo e primeiro arco ortodôntico...

Objective: The aim of this study was to clinically evaluate Low Level Laser Therapy (LLLT) as a method of reducing pain after the first orthodontic archwire placement. Materials and Methods: 90 volunteers received metal braces and the first archwire. They were randomly distributed over three different treatment groups: Group 1- (n=30) Control, patients did not received any LLLT; Group 2- (n=30) Placebo, the LLLT was simulated, the laser was turned off; Group 3- (n=30) Laser patients received LLLT, infra-red with 810 nm wave length and 100 mW power, and it was used 6 J/cm2 as total dose per tooth, divided into four times of 1.5 J/cm2 per 12 seconds per point. Pain intensity experienced was evaluated by a Visual Analogue Scale. Data were tabulated and analyzed through Biostat 4.0 software. Means and standard deviations were calculated and a Kruskal-Wallis statics test was performed (Dunn’s method) (α=0.05). Results: It was possible to observe that the pain started 2 hours after treatment was initiated in the three groups. Higher pain levels occurred between 12 and 48 hours, and pain reduction occurred in 7 days. Group 3 (Laser) presented lower pain data values than the other groups. There was a statistically significant difference (p<0.05) among post operating pain in times T3, T4 and T5 between group 3 and groups 1 and 2. Conclusion: LLLT reduced the pain after orthodontics braces and archwires placement...

Use of glass ionomer cement containing antibiotics to seal off infected dentin: a randomized clinical trial.

Dental materials with antibacterial properties can prevent the harmful effects caused by oral cariogenic bacteria. This double-blind controlled clinical trial evaluated the performance of a glass ionomer cement (GIC) added with antibiotics for sealing infected dentin in atraumatic restorations of primary molars. The study enrolled 45 children (45 teeth) between 5 and 8 years of age, of both genders, divided into two groups: GC (n=22), where cavities were lined with a conventional GIC (Vidrion F) and GA (n=23), with cavities lined with Vidrion F added with 1% each of metronidazole, ciprofloxacin and cefaclor antibiotic. Both groups were restored with Ketac Molar Easymix. Molars with carious lesions on the inner half of dentin without clinical or radiographic pulp damage were selected. Patients were evaluated clinically (pain, fistulas or mobility) and radiographically (area of caries, periapical region and furcation) after 1, 3, 6 and 12 months. For statistical analysis, chi-squared or Fisher's exact tests were used with a 5% significance level. GA (82.6-95.7%) had better results than GC (12.5-36.4%) in all evaluations (p<0.05) and the difference in the success rate was 46.2-72.5% higher for GA. The use of the antibiotic-containing GIC liner on infected dentin proved satisfactory when applied in deciduous teeth.

Study of the antimicrobial efficacy of chlorhexidine in dental unit water: evaluation of microbial contamination in the dental office / Estudo da capacidade antimicrobiana da clorexidina na água do equipamento odontológico: avaliação de contaminação microbiana em ambiente odontológico

Objective: The aim of this study to count anaerobic bacteria before and after the use of dental equipment and to study the influence of chlorhexidine on the dental unit reservoir water. Methods: Sterile swabs were used to collect bacterial samples from the cuspidor, lights, syringes, low-and high speed handpieces and dental chairs (arms and backrest) before and after the placement of barriers. Blood agar plates were placed on the patient's and dentist's forehead and by the patient's nose and shoulder and exposed to aerosoils without (group 1) and with 0,5% (group 2) and 1,0% (group 3) chlorhexidine generated by the high speed handpiece. Ten aerosol samples were collected for each group. A sample of 1mL of the dental unit reservoir water was collected before and after the use of the high speed handpiece. The anaerobic bacterial counts were compared by the Wilcoxon and Kruskal-Wallis tests. Results: The contamination of the high speed handpiece (p=0,0431) and cuspidor (p=0,0117) increased significantly after use. Contamination in the dental unit reservoir water also increased significantly after use of the high speed handpiece. The most contaminated area was the patient's nose. Conclusion: The addition of 0,5% and 1,0% chlorhexidine in the dental office sifnificantly.

ObjetivoO objetivo deste estudo foi quantificar as bactérias anaeróbicas, antes e após o uso deequipamentos odontológicos e estudar a influência da clorexidina na água doreservatório.MétodosOs seguintes itens foram avaliados: cuspideira, luzes, seringas, baixa e alta rotação,braço da cadeira e do encosto com coleções realizadas antes e após a colocação debarreiras. A contaminação microbiana causada pelos aerossóis de alta rotação tambémfoi avaliada: Grupo 1 (controle): (100%) de água no reservatório; Grupo 2: água noreservatório contendo 0,5% de clorexidina, Grupo 3: água no reservatório contendo1,0% de clorexidina. Dez amostras de aerossol foram recolhidos a partir de cadagrupo: placas de ágar-sangue foram colocadas na testa do paciente e do dentista e nonariz e ombro do paciente. Amostra de 1mL a partir do conteúdo da água no reservatóriofoi medida antes e após a utilização de alta rotação. Comparações entre bactériasanaeróbias foram feitas com o uso de Wilcoxon e Kruskal-Wallis teste estatístico.ResultadosVerificou-se um aumento significativo na contaminação antes e após o procedimentoutilizando alta rotação (p=0,0431) e na cuspideira (p=0,0117). Foi possível observarum aumento significativo de contaminação microbiana na água do reservatório, apósa sua utilização. O nariz do paciente era a área mais afetada.ConclusãoA adição de 0,5% e 1,0% de clorexidina no reservatório representa uma reduçãosignificativa de contaminação microbiana gerado no ambiente de um consultório odontológico.

Use of glass ionomer cement containing antibiotics to seal off infected dentin: a randomized clinical trial

Dental materials with antibacterial properties can prevent the harmful effects caused by oral cariogenic bacteria. This double-blind controlled clinical trial evaluated the performance of a glass ionomer cement (GIC) added with antibiotics for sealing infected dentin in atraumatic restorations of primary molars. The study enrolled 45 children (45 teeth) between 5 and 8 years of age, of both genders, divided into two groups: GC (n=22), where cavities were lined with a conventional GIC (Vidrion F) and GA (n=23), with cavities lined with Vidrion F added with 1% each of metronidazole, ciprofloxacin and cefaclor antibiotic. Both groups were restored with Ketac Molar Easymix. Molars with carious lesions on the inner half of dentin without clinical or radiographic pulp damage were selected. Patients were evaluated clinically (pain, fistulas or mobility) and radiographically (area of caries, periapical region and furcation) after 1, 3, 6 and 12 months. For statistical analysis, chi-squared or Fisher's exact tests were used with a 5% significance level. GA (82.6-95.7%) had better results than GC (12.5-36.4%) in all evaluations (p<0.05) and the difference in the success rate was 46.2-72.5% higher for GA. The use of the antibiotic-containing GIC liner on infected dentin proved satisfactory when applied in deciduous teeth.

Os materiais dentários com propriedades antibacterianas podem proteger os efeitos nocivos causados por bactérias cariogênicas. Este ensaio clínico controlado duplo-cego avaliou o desempenho do cimento de ionômero de vidro (CIV) associado à antibióticos no selamento da dentina infectada em restaurações atraumáticas de molares decíduos. O estudo envolveu 45 crianças (45 dentes) entre 5 e 8 anos de idade, de ambos os sexos, divididos em dois grupos: GC (n=22), onde as cavidades foram forradas com CIV convencional (Vidrion F) e GA (n=23), onde as cavidades foram forradas com Vidrion F contendo 1% de cada um dos antibióticos metronidazole, ciprofloxacina e cefaclor. Ambos os grupos foram restaurados com Ketac Molar Easymix. Molares com lesões de cárie na metade interna da dentina, sem danos pulpares clínicos ou radiográficos foram selecionados. Os pacientes foram avaliados clinicamente (presença de dor, fístulas ou mobilidade) e radiograficamente (área de cárie, região periapical e de furca dos dentes), após 1, 3, 6 e 12 meses. Para a análise estatística o Qui-quadrado ou Exato de Fisher foram utilizados com 5,0% de significância. GA (82,6-95,7%) obteve melhores resultados do que GC (12,5-36,4%) em todas as avaliações (p<0,05) e a diferença na taxa de sucesso foi de 46,2-72,5% maior para GA. O uso do CIV com antibióticos no forramento da dentina infectada foi satisfatório em dentes decíduos.

Comparação da taxa de sucesso de quatro soluções anestésicas no bloqueio do nervo alveolar inferior em pacientes com pulpite irreversível. Estudo prospectivo, randomizado, duplo-cego

Objetivo: comparar a eficácia de quatro soluções anestésicas para o bloqueio do nervo alveolar inferior (BNAI) em pacientes com pulpite irreversível. Métodos: esse estudo prospectivo, randomizado e duplo-cego incluiu 60 pacientes adultos que compareceram ao serviço de atendimento de urgência da PUC-Campinas, São Paulo, Brasil. Os pacientes foram divididos aleatoriamente em quatro grupos,com 15 indivíduos cada, e receberam o bloqueio do nervo alveolar inferior: Grupo ART - 2 tubetes de articaína 4% com epinefrina 1:100.000; Grupo LID - 2 tubetes de lidocaína 2%com epinefrina 1:100.000; Grupo PRI - 2 tubetes de prilocaína 3% com felipressina 0,03U.I.; e Grupo MEP - 2 tubetes de mepivacaína 2% com epinefrina 1:100.000. Iniciou-se o acesso cirúrgico após 10 minutos do bloqueio do nervo alveolar inferior e o paciente foi instruído a relatar qualquer sensibilidade ou dor que sentisse durante o procedimento.O BNAI foi considerado bem-sucedido quando o procedimento de acesso e instrumentação foi realizado sem dor para o paciente. Se o paciente sentisse dor, o procedimento era interrompido e a anestesia considerada como insucesso.Resultados: foi utilizado o teste estatístico qui-quadrado para analisar os resultados (α=5%) e não houve diferença significativa (p>0,05) na taxa de sucesso do bloqueio do nervo alveolar inferior entre os grupos: ART = 53,33%, PRI = 46,66% e MEP = 53,33%. Porém, a taxa no grupo LID foi estatisticamente inferior (20%) à dos demais grupos(p<0,05). Conclusão: nenhuma das soluções anestésicas apresentou um índice de sucesso aceitável para o bloqueio do nervo alveolar inferior em pacientes com pulpite irreversível em molares inferiores. A solução de lidocaína 2% com epinefrina 1:100.000 apresentou o pior resultado, quando comparado ao dos demais grupos

Capacity of photodynamic therapy for microbial reduction in periodontal pockets.

Practitioners are not successful in implemented treatments due to the great difficulty in completely removing bacterial deposits and their endotoxins. This study aimed to evaluate the capacity of photodynamic therapy to reduce the numbers of viable bacteria in periodontal pockets. Microbiological samples were collected before and after scaling and after photodynamic therapy. Photodynamic therapy was performed through the insertion of the photosensitizer toluidine blue and Endo PTC into the pocket for 3 min, followed by photosensitization with low-intensity diode of 4 J/cm(2). The results (log(10)) were submitted to a descriptive analysis and a t-test. A reduction of 81.24% in the numbers of bacteria after scaling was observed, as well as 95.90% after photodynamic therapy (P < 0.01). Photodynamic therapy is indicated as an adjuvant treatment to reduce the numbers of viable bacteria in periodontal diseases.

Evaluation of the furcation area permeability of deciduous molars treated by neodymium:yttrium-aluminum-garnet laser or adhesive.

The purpose of this in vitro study was to compare the effects of a self-etch adhesive system and neodymium:yttrium-aluminum-garnet (Nd:YAG) laser application on the dentinal permeability of the furcation area of primary molars. After endodontic access, 39 extracted human deciduous molars were divided into three groups: control group (CG), no treatment; adhesive group (AG), self-etching adhesive was applied to the furcation area; laser group (LG), specimens were irradiated with Nd:YAG laser. To evaluate dentin permeability of the furcation area, we immersed the specimens in 0.5 % methylene blue dye for 4 h. Then, they were longitudinally sectioned into two halves and photographed. The images were analyzed by two qualified evaluators using TpsDig software to calculate the percentage of the dye penetration area in comparison with the total furcation area. Additional analyses by scanning electron microscopy (SEM) were performed. The analysis of variance (ANOVA), complemented by Student's t-test, showed that mean dye penetration in the LG was statistically significant lower than that in all the other groups (P < 0.05). The SEM analysis showed mostly dentinal tubules obliterated by smear layer in the CG; in the AG the smear layer was modified by the adhesive, and, in the LG, melted surfaces were observed. It can be concluded that the Nd:YAG laser was capable of reducing the dentinal permeability of the furcation area of deciduous molars.

Photodynamic therapy in endodontic treatment of deciduous teeth.

The purpose of this study was to evaluate photodynamic therapy in deciduous teeth with necrotic pulp by means of fully quantifying viable bacteria, before and after instrumentation and after the use of photodynamic therapy. Radicular canal cultures were conducted (n = 10): the first one was performed right after access and location of the radicular canal; the second was performed after the conclusion of chemical-mechanical instrumentation, and the last one after photodynamic therapy. The photodynamic therapy was performed with 4 J/cm energy low-intensity diode together with toluidine blue. The results (log(10)) were submitted to a descriptive analysis and Wilcoxon test. The percentage of reduction was submitted to the Mann-Whitney test. The instrumentation resulted in a reduction of 82.59% of viable bacteria, and, after photodynamic therapy, the microbial reduction observed was 98.37% (P = 0.0126). Photodynamic therapy is recommended as adjunct therapy for microbial reduction in deciduous teeth with necrotic pulp.

Prótese em cantiléver: alternativa reabilitadora na perda precoce de dentes decíduos / Fixed prothesis in cantilever: an alternative reabilitation in pediatric dentistry

A Odontologia, em geral, está em constante processo evolutivo. A cada dia, novas técnicas e materiais estão sendo desenvolvidos proporcionando ao clínico e, em especial, ao odontopediatra o uso de técnicas protéticas coadjuvadas com técnicas restauradoras diretas e indiretas. Este artigo tem por finalidade, demonstrar uma técnica alternativa para a reabilitação de um molar decíduo perdido precocemente através da prótese fixa em cantiléver, com um dente pilar e um pôntico, ambos confeccionados e ligados por meio de resina composta fotopolimerizável. Esta alternativa terapêutica demonstrou-se bastante satisfatória quanto à estética, função e aceitação por parte do paciente.

In general, dentistry is in constant evolution process every day new techniques and materiaIs are being developed to allow dentists and, in special pediatric dentists the use of prosthetic restoration concomitantly with direct an indirect restorative techniques. The aim of this article is to show an alternative rehabilitation technique for an early loss of primary molar. A prosthetic cantilever was fixed in the 84 tooth and a pontic in the 85 tooth, both was confectioned with a microhybrid composite resin. This alternative was used as aesthetic fixed space maintenance until the 45 tooth eruption with a good response from the patient.