Photobiomodulation therapy for hypersensitivity associated with molar-incisor hypomineralization: a case report.

Molar-incisor hypomineralization (MIH) is a qualitative defect of the dental enamel on permanent first molars and may be associated with permanent incisors. There is currently no defined therapeutic protocol for managing the hypersensitivity associated with this condition. The present case report describes the treatment of a patient with MIH and the impact on the patient's quality of life as assessed using the Child Perceptions Questionnaire for children aged 11 to 14 years (CPQ11-14). The maxillary central incisors, maxillary and mandibular first molars, and mandibular right canine of an 11-year-old girl were compromised by MIH. The long version of the CPQ11-14 was self-administered before treatment. Initially, the patient reported hypersensitivity of her maxillary right central incisor, maxillary and mandibular left first molars, and mandibular right canine when consuming cold food and beverages. This was confirmed by applying a jet of air to the teeth and asking the patient to report the level of sensitivity using the Wong-Baker FACES Pain Rating Scale. The patient reported that hypersensitivity was present every day or almost every day. Desensitizing treatment included 4 applications of photobiomodulation therapy (infrared diode laser) and 4 applications of fluoride varnish. After desensitization, the maxillary central incisors received direct composite resin restorations, while the maxillary left first molar, which had an amalgam restoration and recurrent caries, received a resin-modified glass ionomer cement restoration. At the conclusion of the treatment, the patient completed the CPQ11-14 again and reported less difficulty with consuming hot and cold foods and beverages, indicating that treatment had reduced hypersensitivity and its negative impact on her quality of life.

Comparative effects of photodynamic therapy mediated by curcumin on standard and clinical isolate of Streptococcus mutans.

AIM: The aim of this study was investigate the effect of photodynamic therapy (PDT) using curcumin (C) as a photosensitizing agent irradiated with an LED (L) in the blue wavelength as a light source on a standard and clinical isolate of Streptococcus mutans (S. mutans) in a planktonic suspension model. MATERIALS AND METHODS: Suspensions of both strains were divided into 4 groups as follows: absence of C and L (control group: C-L-), with C and without L (C group: C+L-), absence of C with L (L group: C-L+) and presence of C and L (PDT group: C+L+). Three different concentrations of curcumin (0.75 mg/ml, 1.5 mg/ml and 3 mg/ml) and three light fluences of studied light source (24, 48 and 72 J cm(-2)) were tested. Aliquots of each studied group was plated in BHI agar and submitted to colony forming units counting (CFU/ml) and the data transformed into logarithmical scale. RESULTS: A high photoinactivation rate of more than 70% was verified to standard S. mutans strain submitted to PDT whereas the clinical isolate showed a lower sensitivity to all the associations of curcumin and LED. A slight bacterial reduction was verified to C+L- and C-L+, demonstrating no toxic effects to the isolated application of light and photosensitizer to both S. mutans strains tested. CONCLUSION: Photodynamic therapy using a combination of curcumin and blue LED presented a substantial antimicrobial effect on S. mutans standard strain in a planktonic suspension model with a less pronounced effect on its clinical isolate counterparts due to resistance to this alternative approach. CLINICAL SIGNIFICANCE: Alternative antimicrobial approaches, as photodynamic therapy, should be encouraged due to optimal results against cariogenic bacteria aiming to prevent or treat dental caries.

Longitudinal effect of curcumin-photodynamic antimicrobial chemotherapy in adolescents during fixed orthodontic treatment: a single-blind randomized clinical trial study.

White spot lesions are one of the concerns during the fixed orthodontic treatment. Thus, the aim of the present study was to evaluate the antimicrobial/anti-inflammatory effect of curcumin-photodynamic antimicrobial chemotherapy (c-PACT) and chlorhexidine varnish on the plaque accumulation and gingival bleeding in adolescents under fixed orthodontic treatment. A randomized clinical trial was performed with an initial number of 45 patients being distributed into three groups: group I-chlorhexidine varnish 2%, group II-placebo varnish, and group III-c-PACT (curcumin at 1.5 mg.mL(-1)) exposed to blue Light-emitting diode (LED) light at 450 nm (power density = 165 mW.cm(-2), fluency = 96 J.cm(-2), total dose = 150.7 J). The treatments were performed for four consecutive times with an interval of 1 week each. After the interventions, two calibrated examiners (Kappa value = 0.75) analyzed the dental plaque accumulation by plaque index (PI) and gingivitis condition by gingival bleeding index (GBI) with 1 and 3 months of follow-up after the treatments comprised a final sample of 35 patients. No significant difference was found to PI between the groups during baseline and 1-month period. Group III (1.52 ± 0.51) presented significance difference from group I (0.91 ± 0.75) and group II (1.03 ± 0.51) at 3 months of follow-up. In this same period, there was more plaque accumulation with significant statistical difference (P ≤ 0.05) in comparison to the other periods to all studied groups. There was a GBI reduction statistically significant to groups I and III at 1-month follow-up in comparison to other periods. No effect was verified to dental plaque accumulation after the photodynamic application mediated with curcumin activated with a blue LED light.

Alternative approach to the management of postoperative pain after pediatric surgical procedures.

AIM: This paper reports two clinical cases in which the application of low-level laser therapy (LLLT) enhanced the postoperative symptoms after pediatric surgical procedures. BACKGROUND: The uses of novel technologies allow more comfort to the patients and ensure a rapid procedure, and LLLT application has shown a positive effect in the prevention of discomfort after invasive procedures. CASE DESCRIPTION: Low-level laser therapy protocol was applied after surgical removal of supernumerary tooth and frenectomy resulting in less swallow and pain with no need of medication intake. CONCLUSION: The laser application was well accepted by both children and parents and showed a clinical efficiency in the follow-up examinations beyond the satisfactory quality of wound healing. CLINICAL SIGNIFICANCE: The LLLT approach is an excellent adjuvant therapy resource for delivery an optimal postoperative after surgical procedures in children. How to cite this article: Paschoal M, Souza J, Santos-Pinto L, Pansani C. Alternative Approach to the Management of Postoperative Pain after Pediatric Surgical Procedures. Int J Clin Pediatr Dent 2014;7(2):125-129.

Therapeutic effects of low-level laser therapy after premolar extraction in adolescents: a randomized double-blind clinical trial.

OBJECTIVE: The purpose of this study was to evaluate the effect of low-level laser therapy (LLLT) on wound healing process and pain levels after premolar extraction in adolescents. BACKGROUND DATA: The advantage of using LLLT in oral surgeries is the reduction of inflammation and postoperative discomfort; however, the optimal dosing parameters and treatment effects in surgical procedures are inconclusive. METHODS: A double-blind, randomized, controlled clinical trial was conducted with 14 patients who were to undergo surgical removal of premolars. Patients were randomly allocated to the LLLT (test) group and placebo (control) group. Patients in the test group received 5.1 J (60 J/cm(2)) of energy density of a gallium-aluminum-arsenide (GaAlAs) diode laser (wavelength, 830 nm; output power, 0.1 W) at three different points intraorally, 1 cm from the target tissue immediately and at 48 and 72 h after the surgical procedure. For patients in the placebo group, the laser device was applied to the same points without activating the hand piece. The wound healing process was evaluated by an independent examiner by visual inspection with the support of digital photographs at baseline and 2, 7, and 15 days postoperatively. Patients recorded the degree of pain using the visual analogue scale (VAS). RESULTS: Compared with the placebo group, the test group showed a lower intensity of pain, but this difference was not statistically significant at any time point. The wound healing process was similar in both groups. CONCLUSIONS: Within the limitations of this study, the LLLT parameters used neither increased the wound healing process nor significantly decreased pain intensity after premolar extraction in adolescents.

Avaliação da superfície de materiais resinosos expostos ao óxido de alumínio / Evaluation of resinous material surfaces exposed to aluminum oxide powder

O objetivo deste estudo foi avaliar o efeito da deposição de óxido de alumínio sobre restaurações resinosas adjacentes a área tratada pelo sistema de abrasão a ar. Foram utilizados 10 terceiros molares devidamente seccionados e incluído sem cera utilidade deixando exposta a face vestibular. Em cada espécime confeccionou-se com a caneta de alta rotação,4 preparos cavitários de aproximadamente 2mm de diâmetro, eqüidistantes de uma linha central demarcada na cera. As 40 cavidades foram restauradas aleatoriamente com resina composta (Silux-3M) e selante resinoso (Fluoroshield-Dentsply). Em seguida, réplicas de cada espécime foram obtidas pela moldagem com silicone (Imprint II-3M) e modeloem resina epóxi (Stycast 1266- Emerson & Cummings). Na seqüência, foram feitas 2 aplicações de 15s do jato abrasivona parte central dos espécimes, utilizando-se o aparelho PrepStar® regulado a 80 psi, com ponta ativa de 45º e 0,48mmde diâmetro interno posicionada a 5mm da superfície. Ao final de cada aplicação, as superfícies foram lavadas, seca se moldadas novamente. Todas as réplicas foram avaliadas em MEV por 2 examinadores calibrados que fizeram uma avaliação cega quanto ao tipo de restauração. Os dados tabulados em escores foram analisados estatisticamente por análise de variância de Friedman. Os resultados evidenciaram que não houve diferença estatística significativa entre as superfícies das restaurações analisadas antes e após a utilização do jato abrasivo (p>0,05). Uma vez que o jato de óxidode alumínio não foi aplicado diretamente sobre as restaurações, provavelmente a baixa energia cinética das partículas periféricas não foi capaz de produzir alterações em suas superfícies.

Evaluation of cutting patterns produced in primary teeth by an air-abrasion system.

OBJECTIVE: The aim of this in vitro study was to assess the effect of tip diameter, nozzle distance, and application time of an air-abrasion system for cavity preparation on the enamel of primary teeth. METHOD AND MATERIALS: Forty exfoliated primary teeth were air abraded with a microabrasion machine used with a handpiece with an 80-degree-angle nozzle, 50-micron abrasive particle size, and 80-psi air pressure. The effects of 0.38- or 0.48-mm inner tip diameter, 2- or 5-mm distance from tip to tooth surface, and 15 or 30 seconds of application time on cutting efficiency were evaluated. Cutting width and depth were analyzed and measured from scanning electron micrographs. RESULTS: Statistical analysis revealed that the width of the cuts was significantly greater when the tip distance was increased. Significantly deeper cavities were produced by a tip with a 0.48-mm inner diameter. The application time did not influence the cuts. CONCLUSION: The cutting patterns found in this study suggest that precise removal of enamel in primary teeth is best accomplished when a tip with a 0.38-mm inner diameter is used at a 2-mm distance.