Uso do laser de baixa potência para o tratamento de parestesia: uma revisão de literatura / Use of low-level laser to treat paresthesia: a literature review

Introdução: A parestesia é uma neuropatia que afeta a função sensorial. O Laser de Baixa Potência (LBP), por sua vez, apresenta propriedades analgésicas, bioestimuladoras e reparadoras. Objetivo: Realizar um levantamento na literatura científica sobre os aspectos gerais e benefícios do LBP no manejo terapêutico da parestesia, além de identificar a classificação e métodos de obtenção do diagnóstico desta condição. Materiais e Métodos: Tratou-se de uma revisão narrativa da literatura através da busca nas plataformas PubMed, SciELO, LILACS e Google Schoolar. Após o cruzamento dos descritores com os operadores booleanos e aplicação dos critérios de inclusão/exclusão, 26 estudos foram incluídos. Resultados: A parestesia pode ser classificada em neuropraxia, axonotmese e neurotmese, subdivididas em Grau I ao V. Seu diagnóstico pode ser executado através de testes subjetivos e objetivos. O LBP compreende em um dispositivo tecnológico com efeitos analgésico, anti-inflamatório e fotobiomodulador, que estimula o reparo neural. Os estudos mostram que a dosimetria nos comprimentos de onda vermelho e infravermelho, aplicação intra e extra oral, e com mais de uma sessão semanal exerce efeito modulatório positivo do reparo neural, com retorno progressivo da atividade sensitiva. Além disso, os estudos trazem uma ampla variação no número de pontos de aplicação, bem como no tempo de irradiação e quantidade de sessões, em virtude da extensão e tempo de diagnóstico da parestesia. Considerações finais: Apesar da alta complexidade da parestesia, o LBP exerce efeitos benéficos através do retorno da sensibilidade parcial ou total, além de ser um dispositivo bem tolerado pelo organismo e minimamente invasivo.

Introduction: Paresthesia is a neuropathy that affects sensory function. The Low-Level Laser (LLL), in turn, has analgesic, biostimulating and reparative properties. Purpose: Carry out a survey at the scientific literature on the general aspects and benefits of LLL in the therapeutic management of paresthesia in addition to identifying the classification and methods for obtaining a diagnosis of this condition. Materials and Methods: It was a narrative literature review through search in platforms PubMed, SciELO, LILACS and Google Schoolar. After crossing the descriptors with boolean operators and applying the inclusion/exclusion criteria, 26 articles were included in this study. Results: Paresthesia can be classified into neuropraxia, axonotmesis and neurotmesis, subdivided into Grades I to V. Its diagnostic can be carried out through subjective and objective tests. The LLL consists in a technological device with analgesic, anti-inflammatory and photobiomodulatory effects, which stimulates neural repair. Studies show that LLL in dosimetry at red and infrared wavelengths with intra and extra oral application and with more than one-week use exerts a positive modulatory effect on neural repair, with a progressive return of sensory activity. Furthermore, the studies show a wide variation in the number of application points, as well as the irradiation time and number of sessions, due to the extent and time of diagnosis of paresthesia. Final Considerations: Despite the high complexity of paresthesia, the LLL has beneficial effects through the return of partial or total sensitivity in addition being a device well tolerated by the body and minimally invasive.

Metabolic landscape of human alveolar type II epithelial cells undergoing epithelial-mesenchymal transition induced directly by silica exposure.

Epithelial-mesenchymal transition (EMT) plays an irreplaceable role in the development of silicosis. However, molecular mechanisms of EMT induced by silica exposure still remain to be addressed. Herein, metabolic profiles of human alveolar type II epithelial cells (A549 cells) exposed directly to silica were characterized using non-targeted metabolomic approaches. A total of 84 differential metabolites (DMs) were identified in silica-treated A549 cells undergoing EMT, which were mainly enriched in metabolisms of amino acids (e.g., glutamate, alanine, aspartate), purine metabolism, glycolysis, etc. The number of DMs identified in the A549 cells obviously increased with the elevated exposure concentration of silica. Remarkably, glutamine catabolism was significantly promoted in the silica-treated A549 cells, and the levels of related metabolites (e.g., succinate) and enzymes (e.g., α-ketoglutarate (α-KG) dehydrogenase) were substantially up-regulated, with a preference to α-KG pathway. Supplementation of glutamine into the cell culture could substantially enhance the expression levels of both EMT-related markers and Snail (zinc finger transcription factor). Our results suggest that the EMT of human alveolar epithelial cells directly induced by silica can be essential to the development of silicosis.

Pulmonary delivery of silver nanoparticles prevents influenza infection by recruiting and activating lymphoid cells.

Silver nanoparticles (AgNPs) are a potential antiviral agent due to their ability to disrupt the viral particle or alter the virus metabolism inside the host cell. In vitro, AgNPs exhibit antiviral activity against the most common human respiratory viruses. However, their capacity to modulate immune responses during respiratory viral infections has yet to be explored. This study demonstrates that administering AgNPs directly into the lungs prior to infection can reduce viral loads and therefore virus-induced cytokines in mice infected with influenza virus or murine pneumonia virus. The prophylactic effect was diminished in mice with depleted lymphoid cells. We showed that AgNPs-treatment resulted in the recruitment and activation of lymphocytes in the lungs, particularly natural killer (NK) cells. Mechanistically, AgNPs enhanced the ability of alveolar macrophages to promote both NK cell migration and IFN-γ production. By contrast, following infection, in mice treated with AgNPs, NK cells exhibited decreased activation, indicating that these nanoparticles can regulate the potentially deleterious activation of these cells. Overall, the data suggest that AgNPs may possess prophylactic antiviral properties by recruiting and controlling the activation of lymphoid cells through interaction with alveolar macrophages.

Assessing the Prevalence and Length of the Anterior Loop of Inferior Alveolar Nerve and the Position and Dimension of Mental Foramen Using Cone Beam Computed Tomography.

Background To prevent harm to the neurovascular bundle during clinical and surgical operations, it is crucial to understand the position and dimension of the mental foramen, as well as the prevalence and length of the anterior loop (AL). Methods An iCAT Vision (CT Dent, London, UK) was used to take a cone beam computed tomography (CBCT) scan. Measurement of height, length of anterior loop, position and width of mental foramen was examined. Results Assessed prevalence of anterior loop and saw difference among genders, which was found to be more among males than females; anterior loop decreased as age advances. Mean anterior loop length of study subjects in different age group on right side was more than the left side, and the most common location of the mental foramen (61.87% in females and 61.36% in males) is located below the apex of the second premolar. The mean value of the distance from inferior border was 9.72mm in females and 10.78mm in males. Conclusion The current study was done with all of these characteristics in mind to assess the effectiveness of CBCT in determining anterior looping of the inferior alveolar nerve (IAN) and the position and dimension of mental foramen. In more than half of the cases analyzed, an anterior loop was discovered.

Sterile inflammation induced by respirable micro and nano polystyrene particles in the pathogenesis of pulmonary diseases.

Sterile inflammation is involved in the lung pathogenesis induced by respirable particles, including micro- and nanoplastics. Their increasing amounts in the ambient and in indoor air pose a risk to human health. In two human cell lines (A549 and THP-1) we assessed the proinflammatory behavior of polystyrene nanoplastics (nPS) and microplastics (mPS) (Ø 0.1 and 1 µm). Reproducing environmental aging, in addition to virgin, the cells were exposed to oxidized nPS/mPS. To study the response of the monocytes to the inflammatory signal transmitted by the A549 through the release of soluble factors (e.g. alarmins and cytokines), THP-1 cells were also exposed to the supernatants of previously nPS/mPS-treated A549. After dynamic-light-scattering (DLS) analysis and protein measurements for the assessment of protein corona in nPS/mPS, real-time PCR and enzyme-linked-immunosorbent (ELISA) assays were performed in exposed cells. The pro-inflammatory effects of v- and ox-nPS/mPS were attested by the imbalance of the Bax/Bcl-2 ratio in A549, which was able to trigger the inflammatory cascade, inhibiting the immunologically silent apoptosis. The involvement of NFkB was confirmed by the overexpression of p65 after exposure to ox-nPS and v- and ox-mPS. The fast and higher levels of IL-1ß, only in THP-1 cells, underlined the NLPR3 inflammasome activation.

Does crown-to-implant ratio affect marginal bone loss around a single short implant at the posterior of the mandible?

Context: Short implants are acceptable treatment options for atrophic ridges; however, they increase the crown-to-implant (C/I) ratio compared to regular length implants. The study aimed to assess the correlation between the C/I ratio and marginal bone loss (MBL) in single short implants at the posterior of the mandible. Aims: The study aimed to assess the correlation between the C/I ratio and MBL in single short implants at the posterior of the mandible. Settings and Design: Cross-sectional study. Materials and Methods: This cross-sectional study assessed short implants with 6 mm lengths at the posterior of the mandible. The long-cone peri-apical digital radiographs were taken immediately after loading and 24 months later. Age, gender, implant diameter, gingival biotype, and implant brands were the study variables, and the C/I ratio was the predictive factor. The mean MBL at 2 years was considered the study outcome. Statistical Analysis Used: The Pearson correlation test was applied to assess the correlation between MBL and C/I. Results: Seventy implants (36 Straumann and 34 SGS implants) were studied. A significant difference was observed in the mean MBL between the two implant brands (P < 0.001). Besides, a correlation was found between MBL and the C/I ratio (P = 0.002). Conclusions: It seems that the C/I ratio is associated with an MBL increase in single short implants at the posterior of the mandible.

Chemotherapy for the treatment of alveolar echinococcosis: Where are we?

Alveolar echinococcosis (AE) is a severe liver disease due to infection with the Echinococcus multilocularis larval stage, called the metacestode. Management of AE is based on benzimidazole chemotherapy (albendazole or mebendazole), associated with surgery when possible. Benzimidazoles are the only compounds recommended for the treatment of AE; however, these are parasitostatic, which means that the parasite can resume growth when treatment is interrupted. Also, benzimidazoles can cause liver dysfunction which may prevent their use. Numerous drugs have been reported to have in vitro activity against E. multilocularis, but few had satisfactory in vivo activity, and none were clearly more effective than benzimidazoles. These drugs belong to various therapeutic categories including anti-infective agents (e.g. amphotericin B, mefloquine, pentamidine derivatives), anti-neoplastic compounds (e.g. imatinib, nilotinib, bortezomib), plant-extracted compounds (e.g. thymol, crocin, carvacrol) and others (e.g. metformin, verapamil, thiaclopride). These treatments are generally of limited interest due to their toxicity, their unfavorable pharmacokinetics, or the scarcity of studies involving humans. Apart from benzimidazoles, only amphotericin B, mefloquine and nitazoxanide have been reported to be used for human AE treatment, with unsatisfactory results. Few studies have aimed at developing innovative strategies for AE drug therapy, such as vectorization of drugs using nanoparticles. Altogether, this review emphasizes the urgent need for new therapeutic strategies in AE management, for which there is currently no curative chemotherapy.

Title: Chimiothérapie de l'échinococcose alvéolaire : où en sommes-nous ? Abstract: L'échinococcose alvéolaire (EA) est une maladie sévère du foie due à l'infection par la forme larvaire d'Echinococcus multilocularis, appelée métacestode. La prise en charge de l'EA repose sur la chimiothérapie par benzimidazolés (albendazole ou mébendazole), si possible associée à la chirurgie. Les benzimidazolés sont les seules molécules recommandées dans le traitement de l'EA, toutefois, ceux-ci sont parasitostatiques, ce qui signifie que le parasite peut reprendre sa croissance lors d'une interruption du traitement. Également, les benzimidazolés peuvent causer une dysfonction hépatique qui peut empêcher leur utilisation. De nombreux médicaments ont été rapportés comme ayant une activité in vitro contre E. multilocularis, mais peu d'entre eux avaient une activité in vivo satisfaisante et aucun n'était clairement plus efficace que les benzimidazolés. Ces médicaments appartiennent à diverses catégories, notamment les agents anti-infectieux (par exemple l'amphotéricine B, la méfloquine, des dérivés de la pentamidine), les composés antinéoplasiques (par exemple l'imatinib, le nilotinib, le bortézomib), les composés extraits de plantes (par exemple le thymol, la crocine, le carvacrol) et d'autres (par exemple metformine, vérapamil, thiaclopride). Ces traitements présentent généralement un intérêt limité en raison de leur toxicité, de leur pharmacocinétique défavorable ou de la rareté des études menées chez l'homme. Outre les benzimidazolés, seules l'amphotéricine B, la méfloquine et la nitazoxanide ont été utilisées dans le traitement de l'EA humaine, avec des résultats insatisfaisants. Peu d'études se sont intéressées à développer des stratégies médicamenteuses innovantes contre l'EA, comme la vectorisation de médicaments à l'aide de nanoparticules. Cette revue souligne le besoin urgent de nouvelles stratégies thérapeutiques dans la prise en charge de l'EA, pour lesquelles il n'existe pas de chimiothérapie curative.

Alveolar macrophage function is impaired following inhalation of berry e-cigarette vapor.

In the lower respiratory tract, the alveolar spaces are divided from the bloodstream and the external environment by only a few microns of interstitial tissue. Alveolar macrophages (AMs) defend this delicate mucosal surface from invading infections by regularly patrolling the site. AMs have three behavior modalities to achieve this goal: extending cell protrusions to probe and sample surrounding areas, squeezing the whole cell body between alveoli, and patrolling by moving the cell body around each alveolus. In this study, we found Rho GTPase, cell division control protein 42 (CDC42) expression significantly decreased after berry-flavored e-cigarette (e-cig) exposure. This shifted AM behavior from squeezing to probing. Changes in AM behavior led to a reduction in the clearance of inhaled bacteria, Pseudomonas aeruginosa. These findings shed light on pathways involved in AM migration and highlight the harmful impact of e-cig vaping on AM function.

Feasibility of Immediate, Early and Delayed Implant Placement for Single Tooth Replacement in the Premaxilla: A Retrospective Cone-Beam Computed Tomography Study of 100 Cases.

AIM: To assess the feasibility of immediate (IIP), early (EIP) and delayed implant placement (DIP) for single tooth replacement in the premaxilla on the basis of the complete indication area of each approach in routine practice. MATERIALS AND METHODS: Data from 100 patients (59 women, 41 men, all Caucasians) aged between 19 and 81 years old (mean age 51.71) who had been consecutively treated with a single implant in the premaxilla (13-23) in one private periodontal practice were retrospectively collected. Demographic data, diagnostic information and linear measurements were extracted from patient files and CBCTs. The feasibility of IIP, EIP and DIP was assessed for all cases by both authors, based on the following criteria: availability of apical bone, position of the tooth in relation to the morphology of the alveolar process, buccal bone morphology and presence of midfacial recession. The reasons for not being able to perform an approach, and the viable alternatives for each approach were secondary outcomes. DIP was considered to have been preceded by alveolar ridge preservation (ARP). RESULTS: Ninety-two patients could be treated by means of IIP, EIP or DIP. In eight patients none of these approaches were possible as they required bone augmentation prior to implant placement. Fifty-two patients (95% CI: 42%-62%) could by treated with IIP, 58 (95% CI: 48%-67%) with EIP and 88 (95% CI: 80%-93%) with DIP. The feasibility proportions of IIP and EIP were significantly lower than the one of DIP (p < 0.001). All patients who could be treated with IIP could also be treated with EIP or DIP. Lack of apical bone for implant anchorage was the main reason for not being able to perform IIP and EIP. Complete loss of the buccal bone wall and the need for bone augmentation prior to implant placement were the reasons for not being able to perform DIP. CONCLUSION: From the results of this retrospective CBCT analysis, DIP is nearly always possible in contrast to IIP and EIP. Therefore, and since it is much easier than IIP and EIP, inexperienced clinicians should mainly focus on ARP and DIP in clinical practice deferring IIP and EIP until more surgical skills have been acquired.

Protective effect of carvacrol hydrogel on the alveolar bone in rats with periodontitis.

OBJECTIVES: This study aimed to investigate the protective effect and mechanism of carvacrol hydrogel on the alveolar bone in rats with periodontitis. METHODS: A thermosensitive hydrogel supported by carvacrol was prepared using poloxamer and hydroxypropyl methyl cellulose as matrix. SD rats were randomly divided into blank group, periodontitis group, blank hydrogel group, and low-, medium-, and high-dose hydrogel groups. The periodontitis symptoms and the CT structure of the alveolar bone were observed. The changes in liver, spleen, kidney, and periodontal tissues were observed. The related indexes of bone metabolism in serum were detected. The expression of osteoprotegerin (OPG) and nuclear transcription factor-κB (NF-κB) pathway proteins was determined by Western blot. The levels of inflammatory factors were assessed by quantitative reverse transcription polymerase chain reaction (qRT-PCR). RESULTS: Carvacrol hydrogel had good slow release, biocompatibility, and cell adhesion. The periodontitis of rats in the carvacrol hydrogel group was significantly alleviated, the expression of OPG protein in gingival tissue was significantly increased (P<0.01), and the levels of receptor activator of NF-κB ligand (RANKL), receptor activator of NF-κB (RANK), NF-κB protein, and inflammatory factors were significantly decreased (P<0.01). CONCLUSIONS: Carvacrol hydrogel can regulate the OPG and NF-κB pathways, reduce alveolar bone absorption, and improve periodontal inflammation.

Prediction of shear stress imposed on alveolar epithelium of healthy and diseased lungs.

Lung alveoli are modeled as spherical caps, lined internally by a thin surfactant-laden liquid film, and the periodic wall shear stress exerted along the epithelium during small-amplitude radial oscillations of their wall is computed. A novel set of boundary conditions, applied at the rim, reveals the dominant role of Marangoni stresses. These stresses develop along the air/liquid interface due to spatial gradients of interfacial surfactant concentration and are transported to the wall by the action of viscosity. The effect of a variety of geometric and functional characteristics, including rim interstitial thickness, alveolar opening angle and liquid film thickness and viscosity, is interrogated, and the results are discussed in relation to the onset and evolution of acute and chronic lung diseases, such as asthmatic attacks, pulmonary emphysema and pulmonary fibrosis.

Pyrroloquinoline Quinone Alleviates Mitochondria Damage in Radiation-Induced Lung Injury in a MOTS-c-Dependent Manner.

Radiation-induced lung injury (RILI) is a prevalent complication of thoracic tumor radiotherapy and accidental radiation exposure. Pyrroloquinoline quinone (PQQ), a novel vitamin B, plays a crucial role in delaying aging, antioxidation, anti-inflammation, and antiapoptosis. This study aims to investigate the protective effect and mechanisms of PQQ against RILI. C57BL/6 mice were exposed to a 20 Gy dose of X-ray radiation on the entire thorax with or without daily oral administration of PQQ for 2 weeks. PQQ effectively mitigated radiation-induced lung tissue damage, inflammation, oxidative stress, and epithelial cell apoptosis. Additionally, PQQ significantly inhibited oxidative stress and mitochondrial damage in MLE-12 cells. Mechanistically, PQQ upregulated the mRNA and protein levels of MOTS-c in irradiated lung tissue and MLE-12 cells. Knockdown of MOTS-c by siRNA substantially attenuated the protective effects of PQQ on oxidative stress, inflammation, and apoptosis. In conclusion, PQQ alleviates RILI by preserving mitochondrial function through a MOTS-c-dependent mechanism, suggesting that PQQ may serve as a promising nutraceutical intervention against RILI.

The age-related effects on orthodontic tooth movement and the surrounding periodontal environment.

Orthodontic treatment in adults is often related to longer treatment time as well as higher periodontal risks compared to adolescents. The aim of this review is to explore the influence of age-related chages on orthodontic tooth movement (OTM) from macro and micro perspectives. Adults tend to show slower tooth movement speed compared to adolescence, especially during the early phase. Under orthodontic forces, the biological responses of the periodontal ligament (PDL) and alveolar bone is different between adult and adolescents. The adult PDL shows extended disorganization time, increased cell senescence, less cell signaling and a more inflammatory microenvironment than the adolescent PDL. In addition, the blood vessel surface area is reduced during the late movement phase, and fiber elasticity decreases. At the same time, adult alveolar bone shows a higher density, as well as a reduced osteoblast and osteoclast activation, under orthodontic forces. The local cytokine expression also differs between adults and adolescents. Side-effects, such as excessive root resorption, greater orthodontic pain, and reduced pulpal blood flow, also occur more frequently in adults than in adolescents.

Neutrophil extracellular traps trigger alveolar epithelial cell necroptosis through the cGAS-STING pathway during acute lung injury in mice.

Extensive loss of alveolar epithelial cells (AECs) undergoing necroptosis is a crucial mechanism of acute lung injury (ALI), but its triggering mechanism needs to be thoroughly investigated. Neutrophil extracellular traps (NETs) play a significant role in ALI. However, the effect of NETs on AECs' death has not been clarified. Our study found that intratracheal instillation of NETs disrupted lung tissue structure, suggesting that NETs could induce ALI in mice. Moreover, we observed that NETs could trigger necroptosis of AECs in vivo and in vitro. The phosphorylation levels of RIPK3 and MLKL were increased in MLE12 cells after NETs treatment (P < 0.05). Mechanistically, NETs taken up by AECs through endocytosis activated the cGAS-STING pathway and triggered AECs necroptosis. The expression of cGAS, STING, TBK1 and IRF3 were increased in MLE12 cells treated with NETs (P < 0.05). Furthermore, the cGAS inhibitor RU.521 inhibited NETs-triggered AECs necroptosis and alleviated the pulmonary damage induced by NETs in mice. In conclusion, our study demonstrates that NETs taken up by AECs via endocytosis can activate the cGAS-STING pathway and trigger AECs necroptosis to promote ALI in mice. Our findings indicate that targeting the NETs/cGAS-STING/necroptosis pathway in AECs is an effective strategy for treating ALI.

Evaluation of alveolar bone loss among diabetic patients with class II amalgam restorations.

The relationship between Class II amalgam restorations and alveolar bone loss among diabetic and non-diabetic patients is evaluated at the Faculty of Dentistry, Najran University, KSA. Hence, we compared type 2 diabetic (n = 32) and non-diabetic patients (n=32) using clinical assessments and imaging techniques. Parameters such as bone loss rate, extent, age, and periodontal condition (plaque index and Gingival Index) were analyzed. Analysis of data shows that diabetic patients on average have higher bone loss.

[Hepatotoxicity due to albendazole: safe alternatives for echinococcosis therapy]. / Hepatotoxizität durch Albendazol: sichere Alternativen bei Echinokokkosetherapie.

Infection with Echinococcus multilocularis leads to the clinical manifestation of alveolar echinococcosis. This is characterized by the formation of alveolar liver tumours, which usually disintegrate necrotically in the course of the disease. Pseudocysts are formed. Especially in the early stages, curative resection followed by long-term treatment with albendazole is recommended. However, the majority of patients are not amenable to curative surgery. In these cases, albendazole therapy is the first-choice treatment. We present a rare case of albendazole-associated hepatitis in a patient with inoperable Echinococcus multilocularis infection, with a favourable outcome following a change in treatment to mebendazole.

The relationship between radiographic measurements of alveolar bone in posterior single-tooth edentulous regions and non-alveolar jawbones using multidetector computed tomography.

OBJECTIVE: This study aimed to evaluate the relationship between radiographic measurements of the alveolar bone in posterior single-tooth edentulous regions and radiographic measurements of non-alveolar jawbones using multidetector computed tomography (MDCT). METHODS: The sample consisted of 47 patients aged between 20 and 42 years who underwent MDCT. All patients had a posterior single-tooth edentulous region. Extraction was performed 1-8 years ago at the time of inclusion (mean = 3.2). The alveolar bone in the edentulous region and non-alveolar bone regions (maxillary tuberosity, condyles, inferior to the mandibular foramen, and mandibular angle) were studied radiographically (radiographic density, dimensions, and cortical bone ratio). Pearson correlation, independent sample t test, and linear regression analysis were used for the statistical analysis. RESULTS: Radiographic density of the alveolar bone (measured in the axial or buccolingual directions) correlated significantly with that of the maxillary tuberosity (0.3 < r < 0.4; P value ≥ 0.001) and, to a lesser extent, with the radiographic density of the region inferior to the mental foramen (r ≈ 0.3). Based on these correlation coefficients, non-alveolar bone density could explain 10-16% of the alveolar bone density after extraction according to linear regression analysis. CONCLUSIONS: This study revealed that alveolar bone radiographic density was correlated with that of the maxillary tuberosity and inferior to the mental foramen region. Accordingly, linear regression models were suggested to aid in predicting future alveolar bone density in areas where extraction is to be performed.

A comparative analysis of postoperative morbidity and alveolar bone regeneration following surgical extraction of impacted lower third molar teeth using piezosurgery and conventional instruments: a split-mouth clinical investigation.

BACKGROUND-OBJECTIVE(S): This randomized, split-mouth study aimed to compare postoperative complications following the surgical extraction of impacted lower third molars using piezosurgery versus conventional rotary instruments. MATERIALS AND METHODS: Twenty-one patients, aged 18-35 years, with bilaterally and symmetrically impacted lower third molars, were randomly assigned to undergo extraction using piezosurgery on one side and conventional rotary instruments on the other. RESULTS: The piezosurgery method required a longer operation time. However, it resulted in quicker resolution of postoperative swelling by the 7th day compared to the conventional method, where swelling persisted longer. Mandibular angle-tragus measurements were significantly higher with the conventional method on the 1st, 3rd, and 7th postoperative days. Although mouth opening decreased significantly after piezosurgery, it returned to preoperative levels by the 7th day, outperforming the conventional method. Postoperative pain was notably higher with the conventional method during the first four days but showed no significant difference from the 5th day onward. Alveolar bone healing was significantly better with piezosurgery at the 3rd and 6th months. Temporary paresthesia occurred in one patient from the conventional group, resolving within four weeks. Neither method resulted in alveolar osteitis. CONCLUSION(S): Within the study's limitations, piezosurgery demonstrated a reduction in postoperative discomfort, suggesting its advantage in enhancing patient recovery following lower third molar extractions. CLINICAL SIGNIFICANCE: Piezosurgery, when used appropriately, can reduce postoperative complications compared to conventional methods. Clinicians should be aware of its indications, benefits, and potential challenges. Trial registration This study was registered as a clinical trial to the ClinicalTrials.gov, and the registration ID is NCT06262841 ( https://clinicaltrials.gov/study/NCT06262841 ).

Morphometric Analysis of the Mandibular Canal and Its Anatomical Variants in a Chilean Subpopulation: Cone Beam Computed Tomography Study.

The inferior alveolar nerve (IAN), contained within the mandibular canal (MC), is a structure prone to damage in clinical and surgical procedures on the mandible. This study aimed to analyze the MC morphology and its anatomical variants in a Chilean subpopulation using cone beam computed tomography (CBCT). In total, 342 images from patients with the following parameters were observed: 120 kV, 9 mA, field of view 12 × 9 MC, and voxel size 0.12 mm. The average length of the MC recorded a mean value of 70.493 ± 4.987 mm on the right side and 70.805 ± 5.177 mm on the left side. The location of the mental foramen (MF) was most frequently found between the mandibular first and second premolar. The greatest bone thickness was found at the level of the basilar border of the 2MPM. The root closest to the MC was distal from the mandibular second molar. The lowest thickness was in the lingual area at 1MM. The prevalence of the anterior loop (AL) (61.5%) and the retromolar canal (RC) (17.5%) showed no significant differences between men and women. The results obtained showed that the morphology of the MC in the Chilean subpopulation can vary.