Effect of low-level laser therapy on orthodontic tooth movement into bone-grafted alveolar defects.

INTRODUCTION: The objective of this study was to investigate the effect of low-level laser therapy (LLLT) on the rate of orthodontic tooth movement (OTM) into bone-grafted alveolar defects based on different healing states. METHODS: Ten male beagles were randomly allocated to 3 groups: group C, OTM alone as a control; group G, OTM into the grafted defects; group GL, OTM into the grafted defects with LLLT. The maxillary second premolars were protracted into the defects for 6 weeks, immediately (G-0 and GL-0) and at 2 weeks (G-2 and GL-2) after surgery. The defects were irradiated with a diode laser (dose, 4.5 J/cm(2)) every other day for 2 weeks. The rates of OTM and alveolar bone apposition, and maturational states of the defects were analyzed by histomorphometry, microcomputed tomography, and histology. RESULTS: The total amounts of OTM and new bone apposition rates were decreased by LLLT, with increased bone mineral density and trabecular maturation in the defects. Group GL-2 had the slowest movement with root resorption in relation to less woven bone in the hypermatured defect. CONCLUSIONS: LLLT significantly decreased the rate of OTM into the bone-grafted surgical defects by accelerating defect healing and maturation, particularly when the start of postoperative OTM was delayed.

Combination of LED light and platelet-derived growth factor to accelerate dentoalveolar osteogenesis.

AIM: This study aimed to evaluate the adjunctive effect of LED light in platelet-derived growth factor (PDGF)-aided dentoalveolar osteogenesis. MATERIAL AND METHODS: Full-thickness osseous wounds were created on rat maxillae and were either unfilled or filled with poly-(D,L-lactide) and poly-(D,L-lactide-co-glycolide) microspheres encapsulating PDGF. Animals received daily 660 ± 25 nm LED light irradiation at 0, 10 (LD), or 20 (HD) J/cm(2) , were killed at days 4-28 (n = 6/group/time) and evaluated by microcomputed tomography (micro-CT), histology, and the expressions of osteopontin and tartrate-resistant acid phosphatase (TRAP). RESULTS: Greater osteogenesis was noted in the PDGF-treated defects at day 14. Under the LED light irradiation, osteogenesis was significantly greater in both LD and HD groups of the non-PDGF-treated defects, but only in the LD group of the PDGF-treated defects. No significant differences in osteogenesis among groups were noted at day 28. Greater bone marrow space was noted in the LED light-irradiated specimens, especially in the PDGF-treated defects at both time points. Osteopontin was significantly promoted in the LD group at both time points, and TRAP was significantly promoted in all LED light-irradiated groups at day 28. CONCLUSION: LED light could an adjunct to promote early PDGF-aided dentoalveolar osteogenesis by facilitating the osteoblast-osteoclast coupling.

Microflora of the oral cavity in patients with xerostomia.

OBJECTIVE: The aim of this study was to evaluate the dependence of the condition of the microflora of the oral cavity on the etiology of xerostomia, patients' sex, age, degree of hyposalivation, and duration of the sense of dryness. MATERIAL AND METHODS: A total of 64 patients with complaints of oral dryness referred to the Clinic of Oral and Dental Diseases, Hospital of Lithuanian University of Health Sciences, for consultation during the period from 2003 to 2005 were selected for the study. The etiological factors of xerostomia were as follows: radiotherapy (PRT) to the maxillofacial area, Sjögren's syndrome (SS), and xerogenic medications, tricyclic antidepressants (TCAs). RESULTS: There were 50 women and 14 men. Their mean age was 60.5 ± 1.6 years. All the patients in the PRT group had high counts of Candida spp. as compared with percentages of patients in the TCA and SS groups (100% vs. 66.7% and 56.2%, P<0.05). Patients' age and sex in different etiology groups had no significant impact on the condition of their oral microflora. There were equal percentages of patients with deficient and normal salivation in the TCA group (44% in both the groups; P<0.01). All the patients in the PRT group had pronounced hyposalivation (P<0.002). A significantly greater percentage of patients with severely reduced salivation had high counts of Lactobacillus spp. (P<0.01). Significantly greater percentages of patients with the clinical duration of xerostomia of up to 6 months had high counts of Lactobacillus spp. and Candida spp. colonies. CONCLUSIONS: In patients with xerostomia, the condition of the microflora of the oral cavity and impairment of major salivary gland function varied according to the etiology of the disease. The level of hyposalivation and the duration of xerostomia were found to have a significant impact on the microflora of the oral cavity.

Enamel matrix derivative and low-level laser therapy in the treatment of intra-bony defects: a randomized placebo-controlled clinical trial.

AIM: The aim of this study was to evaluate the immediate post-operative pain, wound healing and clinical results after the application of an enamel matrix protein derivative (EMD) alone or combined with a low-level laser therapy (LLLT) for the treatment of deep intra-bony defects. MATERIAL AND METHODS: This study was an intra-individual longitudinal test of 12 months' duration conducted using a blinded, split-mouth, placebo-controlled and randomized design. In 22 periodontitis patients, one intra-bony defect was randomly treated with EMD+LLLT, while EMD alone was applied to the contra-lateral defect site. LLLT was used both intra- and post-operatively. Clinical measurements were performed by a blinded periodontist at the time of surgery, in the first week and in the first, second, sixth and 12th month. Visual analogue scale (VAS) scores were recorded for pain assessment. RESULTS: The results have shown that the treatment of intra-bony defects with EMD alone or EMD+LLLT leads to probing depth reduction and attachment-level gain. In addition, EMD+LLLT had resulted in less gingival recession (p<0.05), less swelling (p<0.001) and less VAS scores (p<0.02) compared with EMD alone. CONCLUSION: This study shows that EMD is an effective, safe and predictable biomaterial for periodontal regeneration and LLLT may improve the effects of EMD by reducing post-operative complications.

Nd:YAG laser biostimulation of bisphosphonate-associated necrosis of the jawbone with and without surgical treatment.

Bisphosphonate-associated osteonecrosis was first reported in 2003 and is getting common. Size of lesions, symptoms, and duration of time between starting bisphosphonates and the development of bone necrosis vary. There is currently no effective treatment. We describe our preliminary results with 19 patients affected by bisphosphonate-associated osteonecrosis of the jaws who were treated conventionally with surgical or medical treatment alone or in combination with neodimium: yttrium-aluminium-garnet (Nd:YAG) laser. Clinical variables such as symptoms, presence of pus, and closure of mucosal flaps before and after treatment were evaluated to establish the effect of the laser irradiation. We treated nine patients with laser biostimulation with or without surgical treatment, and in this group there were eight clinical successes and one symptomatic improvement, with a clinical finding better than ones without laser biostimulation (ten patients, five clinical successes, and one symptomatic improvement).

[Use of plasmic irradiator in complex treatment of odontogenic purulent-inflammatory diseases of maxillo-facial region].

The aim of the work was the study of the possibilities of use of plasmatic stream as a therapeutic mean. The work had both experimental and clinical nature. By means of experiments carried out on the rabbits the influence of plasmatic stream on microorganisms, as well as its influence on the processes of reparative regeneration has been studied. It was shown that the plasmic radiation has a strong bactericidal effect, it causes stimulation of reparative regeneration in the soft tissues of the organism. Plasmic therapy speeds up the process of metabolism in the organism, improves microcirculation and stimulates immune responses. Plasma irradiation quickly removes edemas end pain, speeds up healing of infected or aseptic wounds. Use of plasmatic stream in a complex treatment of different diseases considerably speeds up the time of treatment and is very cost-effective.

[Massive lytic osteodystrophy or Gorham-Stout disease of the craniomaxillofacial area]. / L'ostéodystrophie lytique massive ou maladie de Gorham-Stout à localisation craniomaxillofaciale.

Gorham's disease also called idiopathic massive osteolysis represents a rare affection with unknown aetiology. This disease was described in different bones of the body but its location on maxillo-facial skeleton is particular by the number of cases in the world (only 32), by morphological, functional consequences and the prognosis. The authors describe a new case of male teenager (17 years old) who had a massive osteolysis of mandibular ramus, upper maxillary, malaire, sphenoid, temporal and occipital left bone. The authors give precision about epidemiological data, methods of diagnosis and therapeutic procedures.

[Gorham-Stout syndrome--progressive osteolysis with viscerocranial involvement]. / Gorham-Stout-Syndrom--Progressive Osteolyse mit Befall des Viszerokraniums.

Two rather young patients with spontaneous massive mandible osteolysis are presented, i.e. a woman suffering from a rhinogenous liquor fistula and recurrent meningitides, and a young man. The authors discuss etiology, pathologic anatomy, clinical and radiological course, as well as the combined surgical and radiotherapeutical treatment. The pathologic process shall be stopped by the combination of both therapy methods. A radiation dose of 30 to 50 Gy is recommended.