The effect of two phototherapy protocols on pain control in orthodontic procedure--a preliminary clinical study.

Phototherapy with low-level coherent light (laser) has been reported as an analgesic and anti-inflammatory as well as having a positive effect in tissue repair in orthodontics. However, there are few clinical studies using low-level LED therapy (non-coherent light). The aim of the present study was to analyze the pain symptoms after orthodontic tooth movement associated with and not associated with coherent and non-coherent phototherapy. Fifty-five volunteers (mean age = 24.1 ± 8.1 years) were randomly divided into four groups: G1 (control), G2 (placebo), G3 (protocol 1: laser, InGaAlP, 660 nm, 4 J/cm(2), 0.03 W, 25 s), G4 (protocol 2: LED, GaAlAs, 640 nm with 40 nm full-bandwidth at half-maximum, 4 J/cm(2), 0.10 W, 70 s). Separators were used to induce orthodontic pain and the volunteers pain levels were scored with the visual analog scale (VAS) after the separator placement, after the therapy (placebo, laser, or LED), and after 2, 24, 48, 72, 96, and 120 h. The laser group did not have statistically significant results in the reduction of pain level compared to the LED group. The LED group had a significant reduction in pain levels between 2 and 120 h compared to the control and the laser groups. The LED therapy showed a significant reduction in pain sensitivity (an average of 56%), after the orthodontic tooth movement when compared to the control group.

Effect of norbixin-based poly(hydroxybutyrate) membranes on the tendon repair process after tenotomy in rats.

PURPOSE: To determine the efficacy of norbixin-based poly(hydroxybutyrate) (PHB) membranes for Achilles tendon repair. METHODS: Thirty rats were submitted to total tenotomy surgery of the right Achilles tendon and divided into two groups (control and membrane; n = 15 each), which were further subdivided into three subgroups (days 7, 14, and 21; n = 5 each). Samples were analyzed histologically. RESULTS: Histological analysis showed a significant reduction in inflammatory infiltrates on days 7, 14 (p < 0.0001 for both), and 21 (p = 0.0004) in the membrane group compared to that in the control group. There was also a significant decrease in the number of fibroblasts in the control group on days 7, 14 (p < 0.0001), and 21 (p = 0.0032). Further, an increase in type I collagen deposition was observed in the membrane group compared to that in the control group on days 7 (p = 0.0133) and 14 (p = 0.0107). CONCLUSION: Treatment with norbixin-based PHB membranes reduces the inflammatory response, increases fibroblast proliferation, and improves collagen production in the tendon repair region, especially between days 7 and 14.

Association of facial massage, dry needling, and laser therapy in Temporomandibular Disorder: case report.

This case report aims to evaluate the treatment of Temporomandibular Disorder (TMD) of muscular origin by associating facial massage (FM), dry needling (DN), and low-level laser therapy (LLLT). The pre- and post-treatment evaluations consisted of clinical examinations based on the Research Diagnostic Criteria (RDC) for TMD, pain intensity quantification by means of the Visual Analog Scale (VAS), mandibular movement measurement, and electromyographic (EMG) analysis of the masseter and temporal muscles. Post-therapy assessment indicated a decrease in pain sites of 58%, in pain intensity mean (1.3), and an increase in the maximum aperture of 10 mm, in addition to normalization of EMG signals. We conclude that, after application of the treatment protocol, there was a decrease in painful sites, gain in amplitude of mandibular movements, and normalization of EMG activity.

FTIR and SEM analysis applied in tissue engineering for root recovering surgery.

Gingival recession is defined by the displacement of the gingival margin in the apical direction, which overcomes the cementum enamel junction. The etiology of gingival retraction is related to tissue inflammation caused by the accumulation of biofilm, by trauma from brushing action. Aesthetic periodontal surgery aims to return the root coverage to aesthetic harmony, and reduce the risk of periodontal disease and caries. To assist in the root coverage process, the porcine collagen matrix (PCM) has been widely studied. The objectives of this study are to identify the types of collagen that make up the PCM and analyze their morphology. For this, five PCM fragments, 2 mm (thickness) × 2.6 mm (width), were analyzed with the aid of scanning electron microscopy (SEM) and Fourier transform infrared spectroscopy (FTIR). The analysis by SEM showed that the PCM consists of two layers; the surface layer is compact, low porosity, and smooth surface, and a foamed underlying layer has high porosity. Through FTIR we identified that the surface and underlying layers are composed of collagen types I and III, respectively. This biomaterial is conducive to root coverage; it allows adsorption and cell proliferation following the matrix resorption and periodontal tissue neoformation. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 1326-1329, 2017.

Effect of norbixin-based poly(hydroxybutyrate) membranes on the tendon repair process after tenotomy in rats

Abstract Purpose: To determine the efficacy of norbixin-based poly(hydroxybutyrate) (PHB) membranes for Achilles tendon repair. Methods: Thirty rats were submitted to total tenotomy surgery of the right Achilles tendon and divided into two groups (control and membrane; n = 15 each), which were further subdivided into three subgroups (days 7, 14, and 21; n = 5 each). Samples were analyzed histologically. Results: Histological analysis showed a significant reduction in inflammatory infiltrates on days 7, 14 (p < 0.0001 for both), and 21 (p = 0.0004) in the membrane group compared to that in the control group. There was also a significant decrease in the number of fibroblasts in the control group on days 7, 14 (p < 0.0001), and 21 (p = 0.0032). Further, an increase in type I collagen deposition was observed in the membrane group compared to that in the control group on days 7 (p = 0.0133) and 14 (p = 0.0107). Conclusion: Treatment with norbixin-based PHB membranes reduces the inflammatory response, increases fibroblast proliferation, and improves collagen production in the tendon repair region, especially between days 7 and 14.

Association of facial massage, dry needling, and laser therapy in Temporomandibular Disorder: case report / Associação entre massagem facial, agulhamento a seco e laserterapia no tratamento da Disfunção Temporomandibular: relato de caso

ABSTRACT This case report aims to evaluate the treatment of Temporomandibular Disorder (TMD) of muscular origin by associating facial massage (FM), dry needling (DN), and low-level laser therapy (LLLT). The pre- and post-treatment evaluations consisted of clinical examinations based on the Research Diagnostic Criteria (RDC) for TMD, pain intensity quantification by means of the Visual Analog Scale (VAS), mandibular movement measurement, and electromyographic (EMG) analysis of the masseter and temporal muscles. Post-therapy assessment indicated a decrease in pain sites of 58%, in pain intensity mean (1.3), and an increase in the maximum aperture of 10 mm, in addition to normalization of EMG signals. We conclude that, after application of the treatment protocol, there was a decrease in painful sites, gain in amplitude of mandibular movements, and normalization of EMG activity.

RESUMO O objetivo do presente relato de caso é avaliar a associação entre a Massagem Facial (MF), Agulhamento a Seco (AS) e Terapia a Laser de Baixa Intensidade (TLBI) no tratamento da Disfunção Temporomandibular (DTM) de origem muscular. Paciente com DTM crônica foi submetida a 4 sessões de associação entre a MF, AS e TLBI. A avaliação inicial e final foi composta por exame clínico baseado nos Critérios diagnósticos de pesquisa para DTM (RDC - Research Diagnostic Criteria), quantificação da intensidade da dor por meio da Escala visual analógica de dor, mensuração dos movimentos mandibulares e análise eletromiográfica (EMG) dos músculos masseter e temporal. Na pós-terapia, foi observada a redução de 58% dos sítios dolorosos, da média (1,3) da intensidade de dor e aumento de 10 mm na abertura máxima, além da normalização dos sinais EMG. Conclui-se que, após a aplicação de protocolo de tratamento, houve a redução dos sítios dolorosos, ganho de amplitude dos movimentos mandibulares e normalização da atividade EMG.

Efeito da terapia LED na disfunção temporomandibular: estudo de caso / Effect of LED therapy on temporomandibular disorder: a case study

OBJETIVOS: Avaliar o efeito da terapia light emitting diode (LED) na disfunção temporomandibular. DESCRIÇÃO DO CASO: Uma paciente diagnosticada com disfunção temporomandibular foi submetida a quatros sessões de terapia LED com intervalo de sete dias entre as irradiações. No exame inicial da articulação temporomandibular a paciente apresentava abertura de boca sem dor de 23 mm, abertura máxima de 25 mm e abertura máxima com auxílio de 27 mm. Após o tratamento houve aumento de 7 mm na abertura sem dor entre a primeira e a última avaliação enquanto que a abertura máxima de boca e a abertura máxima com auxílio aumentaram 6 mm entre a primeira e a última avaliação. Após 21 dias de tratamento detectou-se redução de 50% dos sítios dolorosos ao exame de palpação. Após o final do tratamento, a escala visual analógica de dor detectou diminuição da intensidade de dor em ambos os lados, e houve diminuição da média total da intensidade de dor. Pela análise das respostas ao questionário Medical Outcomes Study 36- item Short Form Health Survey (SF-36), dos oito domínios de qualidade de vida avaliados, quatro apresentaram melhora. CONCLUSÕES: No protocolo empregado neste caso, após a terapia LED houve redução da intensidade da dor e aumento da amplitude de movimentos mandibulares. A remissão dos sinais e sintomas da disfunção temporomandibular resultou em melhora na qualidade de vida da paciente.

AIMS: To evaluate the effect of light emitting diode (LED) therapy on temporomandibular disorder. CASE DESCRIPTION: A woman diagnosed with temporomandibular disorder was subjected to four LED therapy sessions at a seven-day interval. In the initial examination of the temporomandibular joint the patient presented a mouth opening without pain of 23 mm, a maximum opening of 25 mm and a maximum opening with the aid of 27 mm. After the treatment, there was an increase of 7 mm in the opening without pain between the first and last evaluation, while the maximum opening of the mouth and the maximum opening with aid increased 6 mm between the first and last evaluation. After 21 days of treatment, a 50% reduction in painful sites was detected on the palpation examination. After the end of the treatment, the visual analog pain scale detected a decrease in pain intensity on both sides, and there was a decrease in the total mean pain intensity. By analyzing the responses to the Medical Outcomes Study 36-item Short Form Health Survey (SF-36), of the eight quality of life domains evaluated, four showed improvement. CONCLUSIONS: In this case study, after LED therapy there was reduction in pain intensity and increase of the mandibular range of motion. The resolution of the signs and symptoms of temporomandibular disorder resulted in patient's better quality of life.

Comparison of temperature increase in in vitro human tooth pulp by different light sources in the dental whitening process.

This work evaluated the increase in dental pulp temperature caused by different light sources, used in the dental whitening process, following the irradiation protocol from the light manufacturer. Human incisor, canine and premolar teeth were used. A whitening gel made of hydrogen peroxide 35% v/v and a condenser agent were applied to each tooth, on the vestibular surface, and was activated by five different light sources: photo-polymerizer with blue bandpass filtered halogen lamp (HL) (600 mW, lambda = 430-480 nm), blue light emitting diode (LED) (BL) (1 W, lambda = 470 nm), blue LED associated with infrared diode laser (BL+IL) (120 mW, lambda = 795 nm), green LED (GL) (600 mW, lambda = 530 nm) and green LED associated with infrared diode laser (GL+IL) (120 mW, lambda = 795 nm), with the equipment turned on, an exposure time of 1 min, and resting time of 30 s, repeated three times. The temperature was measured at the beginning and ending of exposure by a digital thermometer (type K thermocouple), placed inside the dental pulp chamber. Analyzing the mean temperature variation that occurred along the irradiation time, we found that the BL and BL+IL group presented the highest temperature variations, mainly in the incisor tooth. The GL and GL+IL presented the lowest temperature increase. The maximum temperature variation reached was 5.5 degrees C for the BL+IL in the incisor tooth. The HL presented a smaller temperature variation than the BL did, but it had a residual temperature when the light was off. The GL and GL+IL promoted a non-significant temperature increase, as low as 1 degrees C, even with total power equal to the that of the HL.

O uso de probióticos na doença periodontal / Use of probiotics in periodontal disease

Objetivo: analisar, através de uma revisão de literatura, o uso de probióticos na doença periodontal. Materiais e métodos: foram pesquisados artigos científicos publicados nos últimos dez anos e referências clássicas abordando o uso de probióticos na Periodontia através dos bancos de dados Medline-Pubmed e Portal de Periódicos Capes. A busca dos artigos incluiu estudos de revisão de literatura e estudos de relato de casos clínicos. Conclusão: esta revisão de literatura não pôde atestar os efeitos benéficos desses micro-organismos em longo prazo, porém, de uma forma geral, houve uma melhoria nos parâmetros clínicos, microbiológicos e imunológicos periodontais. Pesquisas in vivo mais consistentes, através de estudos controlados abordando os principais parâmetros clínicos periodontais, microbiológicos e imunológicos são necessárias para assegurar a eficácia do uso de probióticos como coadjuvantes ao tratamento periodontal.

Objective: to analyze through a literature review the use of probiotics in periodontal disease. Materials and methods: scientific articles published in the last ten years and classic references dealing with the use of probiotics in periodontics were screened the Medline-Pubmed and Portal de Capes journals databases. The articles search included literature review studies and clinical case report studies. Conclusion: this literature review can't state the benefi cial effects of these microorganisms in the long term, but in general there was an improvement in clinical, microbiological and immunological periodontal parameters. More consistent in vivo controlled studies addressing the major periodontal, microbiological and immunological clinical parameters are needed to ensure the efficacy of probiotics as an adjuvant to periodontal treatment.

Previsibilidade em resolução estética para recessões gengivais / Predictability in esthetic solutions for gingival recessions: a case report

A recessão gengival é uma queixa relativamente comum entre os pacientes quando procuram o cirurgião-dentista, e os motivos desse incômodo são sensibilidade e estética. Os autores relatam que o tratamento de recessões gengivais posteriores bilaterais são realizados a partir do transplante do tecido conjuntivo subepitelial. Já a técnica operatória utilizada nesse caso, para o posicionamento do tecido conjuntivo, foi a de Langer, com reposicionamento coronário do retalho. Houve um aumento considerável com relação ao recobrimento radicular, sugerindo um processo de reparação da recessão gengival bilateral, com a interposição do tecido conjuntivo na área receptora. Em relação à praticidade, a técnica de Langer mostra-se mais fácil de ser realizada com relação ao aspecto estético, recobrimento, ganho em altura e espessura. O objetivo desse trabalho é relatar um caso clínico de resolução estética para recessão gengival. A terapia inicial do presente caso consistiu em instruções de higiene oral acompanhado de raspagem dos dentes nos 30 dias anteriores à cirurgia. Os procedimentos cirúrgicos foram feitos seguindo técnica consagrada pela ciência. O enxerto de tecido do palato foi transplantado para a região de recessão, a fim de recobrir as áreas de exposição radicular. O paciente recebeu instruções de cuidados de higiene. Após 14 dias do pós-cirúrgico, realizou-se a remoção dos pontos e uma instrução para higiene permanente do local. O resultado clínico foi uma boa estética para o paciente. Geralmente não possui recidiva mediante cuidados no controle de higiene oral e hábitos.

Gingival recession is a relatively common complaint for patients seeking treatment due to sensitivity and esthetics. The authors report that the treatment of bilateral posterior gingival recessions is performed using the subepithelial connective tissue grafting. The operative technique used in this case was the Langer's method with coronary flap repositioning. There was a considerable increase regarding root coverage, suggesting repair process of the bilateral gingival recession with the interposition of connective tissue in the recipient area. In relation to clinical aspects, the Langer's technique is easier to be performed in relation to the esthetic aspect, coverage, and gains in height and thickness. The purpose of this paper is to report a clinical case to solve the gingival recession. The initial therapy consisted of oral hygiene instructions and root planning 30 days prior to surgery. Afterwards, the surgical procedures were performed accordingly. The graft was harvested from the palate and transplanted to the recession area to cover the areas of root exposure. After 14 days, sutures were removed and oral hygiene instruction was recommended. The clinical results were excellent in terms of esthetics. Generally, no relapse was observed after good oral hygiene and habits.

Terapia LED de baixa intensidade no tratamento da dor durante movimento ortodôntico - Estudo Clínico / Low intensity LED therapy in pain treatment during orthodontic movement ? Clinical Study

Introdução: A terapia com LED de baixa intensidade tem sido reportada por seu efeito analgésico e anti-inflamatório. Objetivo: Analisar a sintomatologia dolorosa após movimentação ortodôntica associada ou não à terapia não-coerente. Método: Vinte nove voluntários (19,8±7,9 anos) selecionados foram divididos em três grupos: controle (n=10), placebo (n=9) e LED (n=10, InGaAlP, 630±10nm, 14J/cm2, 0,10W, 70s). Os participantes tiveram os molares separados ortodonticamente e receberam orientação para anotar o nível de dor entre o momento da separação e 168 horas experimentais. Resultados: O grupo LED apresentou redução (p<0,01) da dor em relação aos grupos controle (2 horas) e placebo (72 horas). O grupo placebo mostrou diminuição (p<0,01) da dor em relação ao grupo controle (6h e 120 horas). Conclusão: Houve efeito positivo da fototerapia nos momentos iniciais da movimentação ortodôntica, sem variações no decorrer do período experimental.

Introduction: Therapy with low intensity LED has been reported for its analgesic and anti-inflammatory effect. Objective: Analyze the pain symptoms after orthodontic tooth movement associated or not to coherent and non-coherent phototherapy. Method: Twenty nine volunteers (19.8±7.9 years) were divided into three groups: control (n=10), placebo (n=9) and LED (n=10, InGaAlP, 630±10nm, 14 J/cm2, 0.10W, 70s). The participants? molars were orthodontically separated, and they were instructed to write down pain level using a visual analog scale between the separator placement and 168 experimental hours. Results: The LED group showed reduction in pain at two hours compared to the control group (72 hours). The placebo group presented a decrease of pain levels in relation the control group (6 and 120 hours). Conclusion: There was positive effect of phototherapy in the early stages of orthodontic movement without variation during the experimental period.

Terapia fotodinâmica antimicrobiana aplicada à periodentia: revisão da literatura e novas perspectivas / Antimicrobial photodynamic therapy applicated on Periodontology: review and news perspective

A terapia fotodinâmica antimicrobiana (TFDa) tem sido amplamente investigada devido à propriedade de reduzir microrganismos. Este estudo se propôs, por meio de revisão da literatura, a avaliar a aplicabilidade da TFDa em Periodontia. Para tal, foram levantados, nos bancos de dados Medline-PubMed, ISI Web of Knowledge, Bireme, Cochrane e SciELO, artigos científicos publicados nos últimos dez anos. A busca dos artigos se restringiu a trabalhos realizados in vivo, tanto em animais quanto em humanos. Os arquivos foram sistematicamente organizados e analisados. Houve expressivo aumento no número de publicações nos últimos dez anos, apontando para o grande interesse científico e clínico no desenvolvimento da TFDa em Periodontia. A diversidade de parâmetros de irradiação e de fotossensibilizantes (FTZs) que atingiram bons resultados inviabiliza indicar um protocolo ideal para a aplicação da terapia. Contudo, clinicamente existe uma maior efetividade dos corantes à base de azul de toluidina, irradiados com lasers de diodo com comprimentos de onda na região do vermelho (l 630-680 nm). A concentração e o tempo de incubação dos FTZs podem variar de acordo com a intensidade da fonte de irradiação, de forma inversamente proporcional. Os resultados clínicos alcançados nos últimos dez anos subsidiam efetivamente a aplicabilidade da TFDa em Periodontia, como importante ferramenta no controle bacteriano em doença periodontal,associado ou não à raspagem e alisamento radicular.

Terapia medicamentosa em cirurgia de remoção de terceiros molares inclusos: revisão de literatura / Drug therapy in surgical removal of wisdom teeth: review

Com a constante evolução da indústria farmacêutica e o aumento da remoção de terceiros molares, diversos protocolos medicamentosos têm sido propostos para reduzir os efeitos do quadro inflamatório que são peculiares a esse tipo de procedimento. Desta forma esta revisão tem por objetivo a análise de protocolos medicamentosos empregados em estudos clínicos controlados, aplicados à cirurgia de remoção de terceiro molar incluso. Foram identificados os principais protocolos medicamentosos utilizados para controle de dor, edema e trismo após cirurgia de remoção de terceiro molar incluso...

With the constant evolution of the pharmaceutical industry and the increased removal of wisdom teeth, several drug protocols have been proposed to decrease the effects of inflammation, which are peculiar this type of procedure. This review aims to analyze drug protocols employed in controlled clinical studies applied to wisdom teeth removal. The main drug protocols used to control pain, swelling, and trismus after wisdom teeth surgery were identified...

Efeito da irradiação LED sobre a microinfiltração auricular em camundongo / Effect of LED irradiation on microcirculation of auricular mouse

A microcirculação pode ser considerada uma unidade funcional do sistema circulatório, sendo constituída pelos menores vasos distais. A radiação eletromagnética pode influenciar essa unidade agindo sobre esfíncteres pré-capilares. Essa influência pode gerar alterações na pressão hidrostática capilar, contribuindo na reabsorção de exsudato inflamatório e eliminando acúmulos de catabólitos intermediários. O efeito da radiação eletromagnética coerente na região do visível (vermelho) tem sido estudado principalmente no processo inflamatório, tendo sido encontrado aumento da permeabilidade capilar e vasodilatação. Contudo, poucos trabalhos foram realizados com o emprego de radiação eletromagnética não-coerente (LED) na região do visível. Dessa forma, o objetivo deste estudo foi observar o efeito do LED (640 :!: 20 nm, 100 m W, 1,77 cm2) sobre a microcirculação auricular em camundongos. Para tal, foram utilizados oito animais divididos em dois grupos (grupo placebo e grupo 3 J/cm2). A superfície auricular externa dos animais foi monitorada (durante 15 minutos) sob microscopia óptica (100x) e analisada com o auxílio do programa ImageJ. Observou-se uma diferença significativa no diâmetro dos vasos nos primeiros minutos após a irradiação, comprovando a existência de um efeito vasodilatador da radiação eletromagnética não-coerente, na região do vermelho, com os parâmetros testados. Esse resultado pode ser otimizado empregando-se maior fluência.

Microcirculation, considered a functional unit of the circulatory system, is composed of many smaller distal vessels. The electromagnetic radiation can influence this unit acting on the precapillary sphincters. This influence might generate alterations on the capillary hydrostatic pressure, contributing to the reabsortion of the inflammatory exudation and eliminating intermediate catabolite accumulation. The effect of coherent electromagnetic radiation on the visible region (red) has been studied mainly in the inflammatory process, and an increase in the capillary permeability and vasodilation was found. However few studies have been conducted on the use of noncoherent electromagnetic radiation (LED) in the visible region. Therefore, the aim of this study was to observe the effect of the LED (640:!: 20 nm, 100 mW, 1.77 cm2) on the auricular circulation of mice. To this end 8 animals were separated into 2 groups (placebo group and 3 J/cm2 group). The external auricular surface was monitored (15 minutes) under light microscopy (100X) and analysed with the help of IMAGEJ program. A significant difference was observed in the vessel diameter in the first minutes after the irradiation, proving the existence of a vasodilator effect of non coherent electromagnetic radiation in the red region of the tested parameters. This result can be optimized with the use of greater fluence.