Fotobiomodulación con láser de baja intensidad en el tratamiento integral ortodóntico: reporte de un caso / Photobiomodulation with low intensity laser in comprehensive orthodontic treatment: report of a case

El apiñamiento dental es una maloclusión frecuen-te y junto con los requerimientos de estética dental son una causa habitual de la solicitud de tratamien-to ortodóncico. El tiempo que demanda y las moles-tias que pudiera ocasionar el tratamiento produce inquietud en los pacientes y un esfuerzo de los or-todoncistas para optimizar el tiempo y prevenir los efectos adversos. Los tratamientos odontológicos multidisciplinarios permiten una mejor respuesta estética, funcional y de estabilidad post tratamiento. El tiempo de alineación dentaria y finalización, en los pacientes tratados con láser de baja intensidad po-dría mejorar tanto los índices gingivales como la res-puesta al dolor. Adicionalmente, las corticales óseas de los pacientes con ortodoncia tratados con láser, podrían verse menos afectadas en comparación con las de los pacientes no tratados. Se presenta un caso de fotobioestimulación con láser de baja intensidad aplicado en un paciente en fase de alineación, que forma parte de un estudio prospectivo aleatorizado que se desarrolla en la FOUBA y fue aprobado por el comité de Ética de la institución. El paciente aceptó y firmó el consentimiento informado. Finalizada la etapa de alineación, se evaluó la efectividad de la te-rapia con láser de baja intensidad actualmente de-nominada fotobiomodulación en incisivos superiores en la fase de alineación para acelerar el movimiento dentario, la respuesta gingival, el dolor, el estado de la cortical alveolar vestibular y la estética del perfil (AU)

Dental crowding, which is a frequent malocclusion, and dental aesthetic requirements are a common cause for requesting orthodontic treatment. The time that the treatment requires and the inconvenience that it could cause worries the patient and makes orthodontists strive to optimize time and prevent adverse effects. Multidisciplinary treatments would allow a better aesthetic, functional and post-treatment stability response. The dental alignment and completion time in patients treated with low-intensity laser could improve both gingival indices and response to pain. Additionally, the bone cortical of orthodontic patients treated with laser could be less affected compared to those of untreated patients. A case of low-intensity laser photobiostimulation applied to a patient in the alignment phase is presented, which is part of a prospective randomized study carried out at FOUBA and was approved by the institution's Ethics Committee. The patient accepted and signed the informed consent. After the alignment phase, the effectiveness of low-level laser therapy actually called photobiomodulation in upper incisors in the alignment phase is evaluated to accelerate tooth movement; the gingival response; the pain; the vestibular alveolar cortical and the aesthetics of the profile (AU)

Effect of a synbiotic on functional abdominal pain in childhood.

BACKGROUND: One of the common functional gastrointestinal disorders in children is functional abdominal pain (FAP). The aim of the present study was to determine whether the administration of a synbiotic composed of fructo-oligosaccharides (FOS) and the seven types of beneficial bacteria is useful in FAP of childhood. METHODS: In this placebo-controlled, double-blind trial, 4-15-year-old children who met the Rome III criteria for FAP were randomly divided to receive either synbiotic or placebo twice daily for 4 weeks. Primary outcome was at least 50% reduction in the number of pain episodes, and secondary outcomes were a decline of at least two scales in the pain duration and intensity based on Wong-Baker scale. Response to therapy was decrease of pain frequency/intensity. RESULTS: A total of 67 children completed the trial (35 with synbiotic). Response rate was higher with synbiotic than placebo after four weeks (53.1 vs 11.4%; p<0.001), and synbiotic had significant superiority to placebo to relieve the duration (4.56±9.12 vs12±18.59, min/day, P=0.04), frequency (0.31±0.53vs 1.17±0.7, episode/Wk., P<.001) and intensity (2.38±2.29 vs 5.49±1.83, p<0.001) of abdominal pain. CONCLUSION: Synbiotic compared to placebo significantly decreased the intensity, frequency and duration of FAP in children.

Effect of Cow's-milk-free diet on chronic constipation in children; A randomized clinical trial.

BACKGROUND: Cow's milk intolerance can lead to chronic constipation in children. The present study seeks to determine the effect of cow's milk-free diet (CMFD) on chronic constipation in children who are not responding to laxatives. METHODS: Seventy children suffering from chronic constipation (described as the Rome III criteria) were enrolled in an open-label randomized clinical study. Each group included 35 children aged 4-14 years treated with laxatives for at least three months with no improvements. The intervention group received CMFD plus calcium supplements for four weeks and the control group did not have any restrictions in consuming cow's milk and dairy products. Also, both groups received polyethylene glycol (PEG; 1 gr/kg/day) and high-fiber foods (at least 10 gr/day) for four weeks. Responsiveness was described as a reduction in symptoms and signs according to the Rome III criteria after four weeks. RESULTS: After four weeks, 25 (71.4%) children in the CMFD group responded to the treatment compared to four (11.4%) children in the control group (P<0.001). Significant differences were found between the CMFD and control groups in terms of the seven Rome III criteria post-intervention; history of large stools (25% vs. 53.6%), large fecal mass in the rectum during examination (17.1% vs. 50%), history of painful defecation (18.2% vs. 55.6%), history of retentive posturing (10% vs. 46%), ≥1 episode/week of incontinence (25 % vs. 50%, P=0.001), ≤ 2 defecations/week (17.4% vs. 52.3%) and history of thick stool with toilet obstruction (22.2% vs. 52.3%). CONCLUSION: This study showed that children with functional constipation with no response to laxatives could benefit from a cow's milk-free and dairy-free diet.

Expansión palatina rápida asistida con mini implantes / Rapid palatal expansion assisted by mini-screws

La atresia o estrechez del maxilar superior es una patología que observamos frecuentemente en nuestra práctica diaria. Es importante el diagnóstico a una edad temprana, no solo para resolver ortopédicamente dicha patología, sino también prevenir una posible cirugía ortognática en la adultez. La expansión palatina rápida es un recurso terapéutico ortopédico para la corrección de la discrepancia transversal esqueletal del maxilar superior, que se manifiesta clínicamente como mordida invertida posterior. Existen diversos tipos de disyuntores y técnicas para su realización. La llegada del anclaje absoluto con los mini-implantes abrió puertas que revolucionan conceptos clásicos de expansión.

Atresia or narrowing of the maxilla is a pathology that we frequently observe in our daily practice. It is important to diagnose at an early age, not only to solve orthopedically this pathology, but also to prevent a possible orthognathic surgery at an adult age. Rapid palatal expansion is an orthopedic therapeutic resource for the correction of the skeletal transverse discrepancy of the maxilla. This pathology manifests clinically as a posterior crossbite. There are different types of expanders and techniques for their realization. The arrival of the absolute anchorage with the mini-implants opened doors that revolutionized classic concepts of expansion

Resolución de clase II mordida profunda con distalamiento molar mini-iimplantoasistida: reporte de caso clínico / Resolution of a class II deep bite with mini-implant-assisted molar distal movement; report of a clinical case

En todos los tratamientos ortodónticos, el primer objetivo a cumplir es alinear y nivelar las piezas dentales. Para tal fin, deberíamos generar espacio dentro del arco dentario. Existen tres procedimientos diferentes para lograr este objetivo, según el grado de apiñamiento dental o Índice de nance, que son los siguientes: a) stripping o desgaste interproximal, b) exodoncia de piezas dentales y c) distalamiento. La distalización de los molares es una de las técnicas más antiguas de la terapéutica ortodóntica y se han empleado distintos recursos terapéuticos para tal fin, como pendulum, jig de jans, first class, entre otros; cada uno con sus ventajas y desventajas. La introducción de los mini-implantes dentro de nuestra especialidad ha revolucionado en forma drástica los conceptos de anclaje, brindándonos movimientos dentarios sin generar efectos colaterales indeseables. El objetivo de este caso clínico, es mostrar la utilización de un Orthorama modificado y mini-implantes como distaladores de los molares superiores (AU)

Comparison of quality of life in low back pain patients and healthy subjects by using WHOQOL-BREF.

BACKGROUND AND OBJECTIVES: Low back pain and consequence disability is one of the most prevalence musculoskeletal disorders that human being ever had involved. Quality of life is a multidimensional concept and is beyond absolute physical health. In this study, we compared QOL between low back pain patients and healthy people using WHOQOL-BREF which is a generic and overall instrument. METHODS: This descriptive-analytic study was carried out on 256 low back pain patients and healthy people in Shahid Beheshti Hospital, Babol. They filled out the questionnaires personally and the scores of different domains in two groups were compared. WHOQOL-BREF has four domains of physical health, psychological health, social relations and environment health. The range of scores in each of these domains is from 4-20. The two questions are about the general quality of life and general health. Overall, a higher score indicates better quality of life. RESULTS: The participants' age range was from 18 to 63 with the mean ± SD of 36.63 ± 10.99. The scores of these four domains and general quality of life and general health of WHOQOL-BREF were lower in low back pain patients. These differences were statistically significant in physical health and environmental health. CONCLUSIONS: Lower QOL in low back pain patients necessitate doing some interventions such as education and rehabilitation in this group. This indicates the importance of more attention to these patients to plan future treatments in order to reinforce these domains.

Glomerular diseases in Iranian children: clinico-pathological correlations.

Glomerular disease constitutes an important part of renal disease. The purpose of this study was to describe and correlate the types of glomerular diseases reported in native kidney biopsy specimens and their clinical presentations in Iranian children. The medical records and pathological diagnoses of patients with glomerular disease whose native kidney biopsy specimens were received by our hospital during a 10-year period were reviewed. In each patient, pathological diagnosis, clinical presentation, age at onset of disease, gender, and presence of nephrotic proteinuria, hematuria, and hypertension, were determined. Minimal-change disease was the most frequent glomerular disease and nephrotic syndrome was the most frequent clinical presentation encountered. For each disease, correlations between the clinical presentation and pathological diagnosis were made. This study describes various glomerular diseases encountered in Iranian children, with their respective clinical presentations.