The effectiveness of low-level laser therapy and low-intensity pulsed ultrasound in reducing pain induced by orthodontic separation: a randomized controlled trial.

BACKGROUND: The low-level laser therapy (LLLT) and low-intensity pulsed ultrasound (LIPUS) have been recently applied to control pain during orthodontic treatment. OBJECTIVE: To evaluate and compare the effectiveness of LLLT and LIPUS in reducing pain induced by orthodontic separation. STUDY DESIGN: A single-blinded randomized controlled trial. METHODS: One hundred and fifty patients were randomly assigned into three groups; LLLT group, LIPUS group, and control group. After 5 min from the separators' placement, the first dose of the laser or the ultrasound was applied, the second dose was applied after 24 h, and the third dose was applied after 48 h on both maxillary and mandibular first molars. The exposure of laser was for 20 s at each point (maxillary and mandibular first molars), with an 810-nm aluminum-gallium-arsenide (AlGaAs) diode laser on continuous mode. The output power set at 150 mW, the energy density of 4 J/cm2, and a laser spot diameter of 7 mm were applied. Whereas the frequency of ultrasonic toothbrush was 1.6 MHz; and average output intensity was 0.2 W/cm2. The application was for 20 min (5 min on each first molar). The control group received the separators without another intervention. A Visual Analog Scale (VAS 100 mm) was used to assess pain intensity at several time intervals during the first four days after the separators' placement. RESULTS: A total of 145 patients were assessed. There was a significant difference in pain perception among the three groups after 5 min (P = .002). The maximum pain level was reached after 24 h. However, the laser group and the ultrasound group showed a statistically significant decrease in pain scores compared to the control group at all the assessment time points (P < .001). Whereas there was no difference between the laser group and the ultrasound group in reducing the pain scores (P > .05). CONCLUSIONS: The LLLT and the LIPUS effectively reduce the separation pain when applied in multiple doses without differences between them. TRIAL REGISTRATION: This trial was registered with the German Clinical Trials Register (DRKS). ( https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID= DRKS00029991). Date of registration: 26/08/2022.

A Fixed Reconstruction and Immediate Rehabilitation of Fully Edentulous Arch Using the All-on-Four Concept: Case Series.

The implant survival largely depends on the mechanical setting in which they work as an independent entity. The implant design, number and position markedly affect the treatment plan. Deficient bone quantity and quality and presence of a vital anatomical landmark have often led the practitioners to conduct researches to find newer ways of implant insertion. One such technique is the 'All-On-4' concept, an alternative to the conventional implant therapy; lessens the amount of strain to the alveolar bone by increasing the antero-posterior spread with distal tilting the posterior implant. It is a cost-effective procedure that decreases the treatment time and the morbidity rate allowing a higher patient quality of life. The article demonstrates clinical cases describing rehabilitation of completely edentulous arches using the All-On-4 concept.

Effect of low-level laser therapy on orthodontic tooth movement during miniscrew-supported maxillary molar distalization in humans: a single-blind, randomized controlled clinical trial.

To investigate the effect of low-level laser therapy (LLLT) on orthodontic tooth movement during maxillary molar distalization over a 12-week observation period. Twenty patients were enrolled in this clinical trial. On the 0th, 3rd, 7th, 14th, 21st, 42nd, and 63rd days following the initial activation of the distalization appliance, laser therapy was applied in a total of 16 different points of the first and second molars for 10 s per point to the randomly determined molar region of the individuals in the intervention group. The amount of molar distalization was measured using digital scans of the three-dimensional (3D) digital models obtained during the 3rd, 6th, 9th, and 12th weeks. The amount of tooth movement on the laser-applied side of subjects in the intervention group was significantly greater than those in the contralateral and control groups at all time intervals (p < 0.001). The amount of tooth movement between the contralateral side of the intervention group and the control group was determined to be statistically insignificant (p > 0.05) at all time intervals. The laser-treated molars of the subjects in the intervention group moved 1.22 times more than the molars in the contralateral side and in the control group in 12 weeks. The rate of tooth movement in the laser, contralateral, and control groups was 0.033, 0.027, and 0.027 mm/day, respectively. Although LLLT was found to be statistically significant in terms of accelerating tooth movement, the effect of LLLT is not considered to be clinically significant. This trial was retrospectively registered (September 22, 2022) at Clinical-Trials.gov (Ref no: NCT05550168).

Laserterapia na otimização do tratamento de osteomielite e osteonecrose dos maxilares / Lasertherapy in the optimization of the treatment of osteomyelitis and osteonecrosis of the jaws

A osteomielite é um processo inflamatório progressivo no tecido ósseo e pode ser agudo, subagudo ou crônico; inicia-se pela medula óssea, dissemina-se e se estende até os tecidos moles vizinhos através do osso envolvendo as porções medulares, corticais, esponjosa e o periósteo, várias condições sistêmicas podem predispor a este processo. A Terapia de Fotobiomodulação (Laserterapia de baixa potência) nada mais é que o uso terapêutico da luz absorvida pelos cromóforos endógenos, desencadeando reações não-térmicas, não citotóxica, biológicas por meio de eventos fotoquímicos ou fotofísicos, levando a mudanças fisiológicas e promovendo redução microbiana, analgesia, modulação da inflamação, angiogênese e reparação tecidual. A Terapia Fotodinâmica Antimicrobiana (aPDT), do inglês Antimicrobial Photodynamic Therapy, é uma modalidade terapêutica antimicrobiana (contra fungos, vírus e bactérias), decorrente da associação de um fotossensibilizador a uma fonte de luz, na presença de oxigênio, com o objetivo de formar Espécies Reativas de Oxigênio. Este trabalho é fundamentado em revisão de literatura científica, com o objetivo de analisar a capacidade da laserterapia na otimização do tratamento da osteomielite e osteonecrose dos maxilares. É possível afirmar que a literatura converge quanto à eficácia, praticidade, segurança e aplicabilidade clínica da fotobiomodulação em doenças ósseas. No entanto, observamos a necessidade da realização de mais trabalhos de pesquisa para definir e aprimorar um protocolo que ofereça praticidade para aplicação do laser no tratamento ou coadjuvante ao tratamento da osteomielite/ osteonecrose dos maxilares.

Osteomyelitis is a progressive inflammatory process in bone tissue and can be acute, subacute or chronic; it begins in the bone marrow, spreads and extends to the neighboring soft tissues through the bone, involving the medullary, cortical, spongy and periosteal portions, several systemic conditions may predispose to this process. Photobiomodulation Therapy (Low Power Laser Therapy) is nothing more than the therapeutic use of light absorbed by endogenous chromophores, triggering nonthermal, non-cytotoxic, biological reactions through photochemical or photophysical events, leading to physiological changes and promoting microbial reduction, analgesia, inflammation modulation, angiogenesis and tissue repair. Antimicrobial Photodynamic Therapy (aPDT) is an antimicrobial therapeutic modality (against fungi, viruses and bacteria), resulting from the association of a photosensitizer to a light source, in the presence of oxygen, with the objective of forming Oxigen-reactive species. This work is based on a scientific literature review, with the objective of analyzing the capacity of laser therapy in optimizing the treatment of osteomyelitis and osteonecrosis of the jaws. It is possible to state that the literature converges regarding the efficacy, practicality, safety and clinical applicability of photobiomodulation in bone diseases. However, we see the need for further research work to define and improve a protocol that offers practicality for the application of laser in the treatment or as an adjunct to the treatment of osteomyelitis/ osteonecrosis of the jaws.

A randomized controlled trial evaluating the effect of two low-level laser irradiation protocols on the rate of canine retraction.

The objective of this study was to evaluate the canine retraction rate with two low-level laser therapy (LLLT) irradiation protocols, involving both a high and a low application frequency. Twenty patients were randomly divided into two equal groups. In Group A, one side of the maxillary arch randomly received LLLT on days 0, 3, 7, 14, and every 2 weeks thereafter, whereas in Group B, one side received LLLT every 3 weeks. Tooth movement was checked every three weeks since the onset of canine retraction, over the 12-week study period. Moreover, Interleukin-1ß (IL-1ß) levels in the gingival crevicular fluid were assessed. Results revealed a significant increase in the canine retraction rate on the laser sides of groups A and B, in comparison with the control sides (p < 0.05), with no significant differences reported between the laser sides in both groups (p = 0.08-0.55). Also, IL-1ß levels were significantly higher on the laser sides of both groups, in comparison with the control sides (p < 0.05). Therefore, LLLT can effectively accelerate tooth movement, with both frequent and less frequent applications, which is attributed to an enhanced biological response as reflected by the elevated IL-1ß levels on the compression sides.

Rapid maxillary expansion supplementary methods: A scoping review of animal studies.

INTRODUCTION: Maxillary constriction is a relatively common condition. Various treatment modalities have been proposed for this condition such as rapid maxillary expansion (RME). Although RME can significantly expand the suture in a relatively short period of time, it has a number of drawbacks, mainly a lengthy retention period. The primary objective of this study was to assess the efficacy of the supplementary methods used in conjunction with RME for new bone formation (NBF) at the midpalatal suture (MPS). Relapse, bone healing, and root resorption were also studied as the secondary outcomes. MATERIALS AND METHODS: The PubMed, Embase, and Cochrane library online databases were searched according to the PRISMA-ScR guideline. Animal studies on the effects of non-surgical supplementary methods other than laser therapy on NBF in RME were included and reviewed. RESULT: Thirty-eight articles met the inclusion criteria. The supplementary methods were categorized into 6 groups: hormones, chemical agents, drugs, vitamins, proteins, and some other substances, which could not be assigned to any group. All the aforementioned substances enhanced NBF. Drugs such as bisphosphonates also increased bone resorption. The oestrogen hormone was shown to reduce treatment relapse. Lastly, stem cell application accelerated bone healing at the expanded MPS. CONCLUSION: Administration of hormones, chemical agents, drugs, vitamins, herbs, and proteins may improve the outcomes of RME, shorten the retention period and consequently, reduce relapse in animals. However, the generalizability of these findings is limited due to the insubstantial number of studies published on each substance.

Patient-reported outcomes in patients with severe maxillary bone atrophy restored with zygomatic implant-supported complete dental prostheses: a systematic review.

Introduction and Objective: Zygomatic implants (ZI) offer a good and predictable alternative to reconstructive procedures of atrophic maxillae. The main objetive of this systematic review was to assess the effect of rehabilitation with zygomatic implants on patient's quality of life (QLP) using Patient Reported Outcomes Measures (PROMs).Materials and Methods: This review followed PRISMA guidelines. An automated electronic search was conducted in four databases supplemented by a manual search for relevant articles published until the end of January 2021. The Cochrane Collaboration Risk of Bias tool and the Newcastle-Ottawa Quality Assessment Scale were used to assess the quality of evidence in the studies reviewed.Results: General findings of this systematic review showed substantial increases in Oral health-related quality of life (OHRQoL) among patients restored with ZI and high scores in terms of general satisfaction, especially in chewing ability and esthetics. An overall survival rate of ZI was 98.3% after a mean follow-up time of 46.5 months was observed. Occurrence of 13.1% biological complications and 1.8% technical complications were reported.Conclusions: Patients rehabilitated with zygomatic implant-supported complete dental prostheses showed substantial improvements in OHRQoL and general satisfaction with the treatment received.

Stereophotogrammetry to evaluate young adults with and without cleft lip and palate after orthodontic and restorative treatment.

STATEMENT OF PROBLEM: Patients with cleft lip and palate generally present with lateral incisor agenesis, which may be treated with an implant-supported prosthesis. However, whether implants can stabilize the dental arches in patients with cleft lip and palate is unclear. PURPOSE: The purpose of this retrospective clinical study was to analyze the stability of the maxillary dental arch after orthodontic treatment and oral rehabilitation in the cleft area with an implant-supported prosthesis or a fixed partial denture. MATERIAL AND METHODS: Fifty-five participants, 20 with unilateral cleft lip and palate rehabilitated with implants (CLPI), 15 with unilateral cleft lip and palate rehabilitated with fixed partial dentures (CLPFP), and 20 in the noncleft group (NCLP) and their gypsum casts (N=110) were digitized and evaluated through 3D stereophotogrammetry. Measurements were made on casts obtained immediately after the orthodontic treatment (T1); for the cleft lip and palate group, casts were made 1 year after implant-supported restoration placement (T2), and for the noncleft group, 1 year after the conclusion of the orthodontic treatment (T2). The dimensions of the dental arches were measured digitally. Formula Δ=T2-T1 evaluated the stability of dental arches for intercanine distances, intermolar distances, arch length, palate surface, and volume (3D). Stability (Δ) was compared through 1-way ANOVA in all groups (α=.05). RESULTS: A statistically significant difference was found in the stability of the CLPI and CLPFP groups for intercanine measurement (P=.002). For the intermolar measurement, a statistically significant difference was detected between the CLPFP and NCLP groups (P=.002). From the 3D measurements, the stability was similar in all groups. CONCLUSIONS: In patients with clefts, a fixed partial denture may provide better stability of the orthodontic outcomes than an implant-supported prosthesis. However, greater instability occurred at the molar area.

Effect of methylphenidate at different doses on new bone formation with rapid maxillary expansion: A micro-CT and histomorphometric study in rats.

OBJECTIVES: This study aimed to evaluate the effect of systemically administered methylphenidate hydrochloride (MPH) on new bone formation in premaxillary suture after rapid maxillary expansion (RME). SETTING AND SAMPLE POPULATION: Thirty-three Wistar rats were divided into four groups: Group 1 (high dose, 30/60 mg/kg MPH), Group 2 (low dose, 4/10 mg/kg MPH), Group 3 (positive control) and Group 4 (negative control). METHODS: RME was applied on the 70th day of the study. A 5-day RME period was followed by a 12-day retention period. The experiment was terminated on the 87th day. Micro-CT for radiological evaluation, haematoxylin-eosin and Masson's trichrome staining methods were used for histomorphometric evaluation. RESULTS: Among experimental groups with RME, the lowest number of osteoblasts and capillaries in Group 1 (P < .05). New bone formation, fibrous callus formation, distal osteotomy line, proximal osteotomy union and cortex remodelling were observed to be lower in Group 1 and Group 2 than Group 3 (P < .05). There was a statistically significant difference between Group 4 and each of the other groups (P = .000) in the evaluation of the results for bone mineral density, bone volume, bone volume percentage, trabecular thickness and trabecular number. CONCLUSIONS: MPH reduces cellular activity for new bone formation in suture in RME groups. Before performing rapid maxillary expansion in patients using MPH, the use of the drug should be postponed after a multidisciplinary decision process or clinical doses should be lowered.

A Randomized Triple-Blind Clinical Trial of the Effect of Low-Level Laser Therapy on Infiltration Injection Pain in the Anterior Maxilla

Abstract Objective: To evaluate the level of pain experienced during infiltration anesthesia of the anterior maxilla following low-level laser therapy (LLLT) with 810-980 nm wavelengths. Material and Methods: In the current triple-blind clinical trial, 84 patients received a total of 168 infiltration anesthesia injections (1.8 mL of 2% lidocaine plus 1:100,000 epinephrine) in the anterior maxilla. Each patient received two injections into the buccal mucosa of the right and left central incisors with a two-week interval. One injection was performed after LLLT, while the other injection was administered conventionally without laser. The pain level was measured immediately after injection using a visual analog scale (VAS). Results: There was a significant difference in the pain level experienced with and without LLLT, such that the mean pain score following LLLT was significantly lower than that without LLLT (p<0.05). No significant difference was found in the pain level between laser and no laser groups in males, but the difference in this regard was significant in females (p<0.05) and female patients experienced a significantly lower level of pain following LLLT. Conclusion: The low-level laser therapy can be successfully used to decrease the level of pain experienced during infiltration anesthesia of the anterior maxilla (AU).

Early Dental Trade Card for a Dentist & Cupper.

Very few "Dentist AND Cupper" trade cards are known and this is the only illustrated one known to the authors. "Mr. Glissan, Dentist and Cupper, 147 Blackfriars Road, (London), Teeth extracted for the Poor Gratuitously." Above the text and in the center is a eight-sided brass boxed scarificator. Developed in the 18th century as a more humane and efficient instrument for bloodletting than lancets or fleams, scarificators had multiple blades that shot out with the press of a spring-loaded lever creating an instantaneous series of parallel cuts in the skin of the patient. After the cuts were made a warm glass cup (to create a vacuum) was applied to drain blood. Two of these cups are pictured on each side of the scarificator. A mandible to the left and a maxilla to the right are also pictured. An explanation of the ancient procedure of cupping can be accessed at: https://www.webmd.com/balance/guide/cupping-therapy#1 (accessed 30 October 2020). Mr. Glessan's offer of free extractions for the poor is not unknown but seldom found on early dentist's trade cards.

Stimulating GABAergic Neurons in the Nucleus Accumbens Core Alters the Trigeminal Neuropathic Pain Responses in a Rat Model of Infraorbital Nerve Injury.

The nucleus accumbens core (NAcc) is an important component of brain reward circuitry, but studies have revealed its involvement in pain circuitry also. However, its effect on trigeminal neuralgia (TN) and the mechanism underlying it are yet to be fully understood. Therefore, this study aimed to examine the outcomes of optogenetic stimulation of NAcc GABAergic neurons in an animal model of TN. Animals were allocated into TN, sham, and control groups. TN was generated by infraorbital nerve constriction and the optogenetic virus was injected into the NAcc. In vivo extracellular recordings were acquired from the ventral posteromedial nucleus of the thalamus. Alterations of behavioral responses during stimulation "ON" and "OFF" conditions were evaluated. In vivo microdialysis was performed in the NAcc of TN and sham animals. During optogenetic stimulation, electrophysiological recordings revealed a reduction of both tonic and burst firing activity in TN animals, and significantly improved behavioral responses were observed as well. Microdialysis coupled with liquid chromatography/tandem mass spectrometry analysis revealed significant alterations in extracellular concentration levels of GABA, glutamate, acetylcholine, dopamine, and citrulline in NAcc upon optic stimulation. In fine, our results suggested that NAcc stimulation could modulate the transmission of trigeminal pain signals in the TN animal model.

Effect of revascularisation and apexification procedures on biomechanical behaviour of immature maxillary central incisor teeth: a three-dimensional finite element analysis study.

OBJECTIVES: This study aimed to assess the effects of revascularisation and apexification procedures on biomechanical behaviour of immature teeth using 3-dimensional finite element analysis (3D FEA). MATERIALS AND METHODS: Five 3D FEA permanent maxillary incisor models were developed from CBCT scans and available literature data: Model MT: Mature tooth, Model IT: Immature tooth (Cvek's stage 3), Model AT: Apexified tooth-mineral trioxide aggregate (MTA) apexification, Model RTB: Revascularised tooth with blood, and Model RTS: Revascularised tooth with supplementary scaffold. Using FEA, a masticatory load of 240N at 120° was simulated, and the Von Mises and maximum principal stresses within the models were evaluated. Failure index (FI) and weakening% were also calculated for each model. RESULTS: On dentinal stress analysis, model MT (96.16MPa) and IT (158.38MPa) had lowest and highest stress values, respectively. Among the experimental groups, model RTS (131.12MPa) had lower stresses than AT (136.33MPa) and RTB (133.7MPa), with no significant difference among the three. Peak dentinal stresses in all the models were observed in the cervical third of the root and near the apical opening in model IT. The extent of high dentinal stress area in model RTB and RTS was lesser than that of AT. The FI and weakening% values were highest for model AT followed by RTB and RTS, among the experimental groups. However, all these treatments strengthened an immature tooth by more than 20%. CONCLUSIONS: AT, RTB, and RTS treatments lowered the stress values and risk of fracture in immature teeth with no significant difference among the three groups. CLINICAL RELEVANCE: Stress distribution evaluation following revascularisation/apexification was essential, with potential to influence clinical decision-making. MTA apexification and revascularisation with blood clot/supplementary scaffold lowered the stresses in immature teeth, with no significant difference among the three.

Six-year clinical outcomes of implant-supported acrylic vs. ceramic superstructures according to the All-on-4 treatment concept for the rehabilitation of the edentulous maxilla.

The aim of the current study was to document the long-term clinical results of the use of two prosthetic techniques for the rehabilitation of completely edentulous maxillae according to the "All-on-Four" concept: Fixed, screw-retained prosthesis mounted on a chrome-molybdenum framework with (1) metal-ceramic veneers and (2) Acrylic prosthesis with acrylic resin prosthetic teeth. A total of 34 patients were assigned to subgroups according to their own preference of the superstructure type (ceramics [n: 17] or acrylic resin [n: 17]). Prosthetic complications, marginal bone loss, plaque accumulation, bleeding on probing, bite force and oral-health-related quality of life were assessed over a period of 6 years. Marginal bone loss around implants of the ceramic group remained well within the limits for 'success', as defined by the 2007 Pisa consensus over the time (1.43 ± 0.35 mm). However, marginal bone loss was significantly more pronounced around the implants in the acrylic group (2.15 ± 0.30) and the difference between two groups was statistically significant (p: 0.00). Bleeding on probing and plaque accumulation showed also positive correlation with marginal bone loss. Both acrylic and ceramic suprastructures appeared to be equivalent after 6 years; however, ceramic suprastructures revealed superior clinical results in terms of bone loss and plaque accumulation. Current study determines the long-term clinical outcomes of different prosthetic management alternatives in All-on-Four and aids to increase dental professionals' ability to meet the patients' expectations.

Comparison of rapid maxillary expansion and pre-fabricated myofunctional appliance for the management of mouth breathers with Class II malocclusion.

OBJECTIVE: Pre-fabricated myofunctional appliances and rapid maxillary expansion (RME) has been used for the treatment of mouth-breathers with Class-II malocclusion. This study aimed to compare the treatment effects of hyrax and pre-fabricated myofunctional appliance (T4K) for the management of mouth breathers with Class II Malocclusion in mixed dentition stage. PATIENTS AND METHODS: Case records of mouth breathers with Class II Division 1 malocclusion patients treated at our institute with T4K or hyrax appliance between June 2015 to May 2019 were retrieved. The Pancherz analysis was used to compare the treatment effects. RESULTS: Data of 28 patients (14 in each group) were compared. Significant advancement of maxilla was seen in both groups while mandibular length improved only with the T4K appliance. SNA and SNB changes were significantly greater in the T4K group. Molar relationship improved in both groups. Molar correction was obtained by 55.6% skeletal change and 44.4% dental change with RME. In the T4K group the corresponding values were 48.1% and 51.9% respectively. CONCLUSIONS: Our results suggest that both pre-fabricated myofunctional appliance and RME are suitable for the treatment of mouth breathers with Class II malocclusion in the mixed dentition period. Sagittal correction of maxilla and mandible may be somewhat better with the T4K appliance. Although the dental compensation may be slightly more with the T4K appliance and it may inhibit the skeletal remodeling.

Which method is more effective for accelerating canine distalization short term, low-level laser therapy or piezocision? A split-mouth study.

OBJECTIVES: This study evaluated and compared the effects of low-level laser therapy (LLLT) and piezocision on the amount of orthodontic tooth movement. MATERIALS AND METHODS: Forty maxillary canines from 20 patients (mean age, 16.35 ± 1.14 years) were evaluated in a split-mouth design study. Miniscrew-supported canine distalization was performed. Piezocision was applied in the right maxillary canine region, and the left maxillary canines were irradiated with a diode laser (940 nm, 5 J/cm2). LLLT was performed on day 0 and days 3, 7, 14, 21, and 28 after the start of canine distalization in the first 4­week period. Data were evaluated at baseline (T0) and after 4 (T1), 8 (T2), and 12 (T3) weeks. The amount of canine movement was determined from three-dimensional models, and the angulation of canines and first molars was analyzed based on lateral cephalograms. RESULTS: Intragroup and intergroup comparisons of canine distalization were performed for four different time intervals (T0-T1, T1-T2, T2-T3, T0-T3). The canine tooth movement in the T0-T1 period was significantly greater in the LLLT group compared to the piezocision group. No statistically significant differences were observed between the groups for the T1-T2, T2-T3, and T0-T3 periods. The amount of canine distalization in the T0-T1 period was significantly greater than that in the T1-T2 and T2-T3 periods in both groups. Tooth movement during the T1-T2 period was higher than that in the T2-T3 period in the LLLT group. Cephalometric evaluation revealed no statistically significant difference between the groups with respect to canine and first molar angulation. CONCLUSION: Although laser application seems more effective during the first 4­week period, considering the 12-week period, the effects of LLLT and piezocision on orthodontic tooth movement during canine distalization were similar.

Avaliação da ozonioterapia no tratamento da osteonecrose induzida por zoledronato em ratas senis / Evaluation of ozone therapy in the treatment of zoledronate-induced osteonecrosis in senile rats

A ozonioterapia vem se demonstrando uma ferramenta promissora na prevenção de infecções e no auxílio da reparação tecidual, conciliando com os desafios no tratamento da osteonecrose dos maxilares induzida por medicamentos (ONM-M), este projeto objetiva analisar os efeitos da ozonioterapia, em 55 ratas senis (18 meses), entre 300-350g, induzidas a osteonecrose via medicamentosa (Zoledronato 100µg/kg), após exodontia do primeiro molar inferior. Os animais foram divididos em 4 grupos equitativos (10 ratas por grupo), o primeiro grupo SAL, recebeu aplicações de soro fisiológico por 7 semanas, grupo SAL + OZ recebeu aplicações de soro fisiológico por 7 semanas e o tratamento com a ozonioterapia (0,7mg/kg) a cada 2 dias por 28 dias, o grupo ZOL recebeu aplicações de zoledronato (100µg/kg) por 7 semanas e por último o grupo ZOL + OZ recebeu também aplicações de zoledronato no mesmo protocolo e foi tratado com a ozonioterapia (0,7mg/kg) a cada 2 dias por 28 dias. Todos as ratas receberam a antibioticoterapia (Cristacilina® 0,1ml/kg por dia) iniciando 3 dias antes do procedimento de extração, se estendendo até 4 dias de pós-operatório, passaram pela extração do molar na terceira semana de experimento e foram submetidas a eutanásia na sétima semana de experimento. Após a eutanásia as mandíbulas foram ressecadas, reduzidas e preparadas para as análises microtomográficas (caracterização óssea do osso senil (MCT0) e após terapia com zoledronato (MCT1ZOL) contra seu par controle (MCT1SAL), parâmetros volumétricos (Bv,Bv.Tv,Tb.Th,Tb.N,Tb.Sp,Po.Tot) dos grupos experimentais), histométricas (porcentagem de osso neoformado e porcentagem de osso não vital) e imunoistoquímicas (expressão de TNFa, IL-1b, VEGF, OCN e TRAP). Os resultados da caracterização óssea não apresentaram diferença quando comparado os grupos experimentais (p> 0,05), possivelmente devido ao pouco tempo decorrido na terapia com zoledronato. Os demais resultados comparando os grupos experimentais mostrou com diferenças estatisticamente significativas (p< 0,05) uma característica de osso vítreo, denso, sem vitalidade, pobre em vascularização, com elevados valores para marcadores de inflamação, traduzindo isso em osteonecrose dos maxilares relacionada com a medicação, destoando principalmente do grupo controle SAL, que apresentou melhora na reparação alveolar e características de osso vital e vascularizado. A ozonioterapia (ZOL+OZ, SAL+OZ) apresentou valores significantes estatisticamente quando comparado ao grupo sem tratamento, traduzindo em melhora na vascularização do tecido ósseo, em melhora reparacional do alvéolo, modulação da inflamação local e o aparecimento/manutenção de células osteoblásticas ativas (p< 0,05). Mostrando-se uma terapia viável no controle/tratamento da osteonecrose dos maxilares relacionado com medicamentos(AU)

Ozone therapy has been shown to be a promising tool in the prevention of infections and in the aid of tissue repair, reconciling with the challenges in the treatment of medication-induced jaw osteonecrosis (ONM-M), this project aims to analyze the effects of ozone therapy in 55 rats senile (18 months), between 300-350g, induced to osteonecrosis via medication (Zoledronate 100µg / kg), after extraction of the lower first molar. The animals were divided into 4 equitable groups (ten rats per group), the first SAL group, received saline applications for 7 weeks, SAL + OZ group received saline applications for 7 weeks and ozone therapy (0, 7mg / kg) every 2 days for 28 days, the ZOL group received applications of zoledronate (100µg / kg) for 7 weeks and lastly the ZOL + OZ group also received applications of zoledronate in the same protocol and was treated with ozone therapy (0.7mg / kg) every 2 days for 28 days. All rats received antibiotic therapy (Cristacilina® 0.1ml / kg per day) starting 3 days before the extraction procedure, extending up to 4 days after the operation, underwent molar extraction in the third week of the experiment and were submitted to euthanasia in the seventh week of experiment. After euthanasia, the mandibles were resected, reduced and prepared for microtomographic analysis (bone characterization of senile bone (MCT0) and after therapy with zoledronate (MCT1ZOL) against its control pair (MCT1SAL), volumetric parameters (Bv, Bv.Tv, Tb .Th, Tb.N, Tb.Sp, Po.Tot) of the experimental groups), histometric (percentage of newly formed bone and percentage of non-vital bone) and immunohistochemistry (expression of TNFa, IL-1b, VEGF, OCN and TRAP) . The results of bone characterization did not show any difference when comparing the experimental groups (P> 0.05), possibly due to the short time elapsed in zoledronate therapy. The other results comparing the experimental groups showed with statistically significant differences (P < 0.05) a characteristic of vitreous bone, dense, without vitality, poor in vascularization, with high values for inflammation markers, translating this into a related jaw osteonecrosis with medication, disagreeing mainly with the SAL control group, which showed improvement in alveolar repair and characteristics of a vital and vascularized bone. Ozone therapy (ZOL + OZ, SAL + OZ) showed statistically significant values when compared to the untreated group, translating into an improvement in bone tissue vascularization, a reparational improvement of the alveolus, modulation of local inflammation and the appearance/maintenance of cells active osteoblasts (P < 0.05). Showing to be a viable therapy in the control/treatment of osteonecrosis of the jaws related to drugs(AU)

Advance in Functional Restoration of Injured Nerve with Low Level Laser and its Utilization in the Dental and Maxillofacial Region.

The inferior alveolar nerve and facial nerve are the two most important nerves in the dental and maxillofacial region. The injury to them is one of the major postoperative complications after alveolar surgery and orthognathic surgery. However, recovering the nerve function after injury takes a long time and the recovery effect tends to be unsatisfactory. In recent years, an intensively investigated technique, low level laser which has been applying in assisting the recovery of nerve function, has been gradually proved to be effective in clinically treating postoperative nerve injury. In this article we review in terms of the mechanisms involved in low level laser-assisted functional restoration of nerve injury and its clinical application in the recovery of nerve function in the dental and maxillofacial area as well.

Zygomatic implant survival in 9 ectodermal dysplasia patients with 3.5- to 7-year follow-up.

OBJECTIVE: Ectodermal dysplasia syndrome is a complex group of genetic disorders identified by the abnormal development of the ectodermal structures. The aim of this retrospective clinical case series report was to evaluate the outcomes of the ectodermal dysplasia syndrome patients that underwent zygomatic implant surgery. MATERIALS AND METHODS: A total of 9 ectodermal dysplasia syndrome patients aged between 21 and 56 years (mean age 36.8) with severely atrophic maxilla were included in this study. All the patients were treated with a total of 19 zygomatic implants. The mean follow-up of the patients was 55 months (with a range of 44-84 months). The implant survival rate was evaluated as a primary outcome. The intra- and postoperative complications were evaluated as additional criteria for success. RESULTS: The overall implant survival rate was 100% without any complications. Final or provisional prosthesis was delivered on the same day of surgery, which resulted in an improvement of the quality of life of the patients. CONCLUSION: According to the results of this study, zygomatic surgery can be considered as a viable and safe alternative to conventional treatment modalities for oral rehabilitation of ectodermal dysplasia syndrome patients.